Stimulation of the left vagus nerve is a well-established therapy for patients with drug-resistant epilepsy who are not candidates for resective or disconnection surgery. Right-sided vagus nerve stimulation is generally avoided due to concerns about serious cardiac side effects, as the right vagus nerve is anatomically associated with the innervation of the sinoatrial node. Only a few cases of right-sided vagus nerve stimulation in drug-resistant epilepsy have been reported to date.

An 8-year-old child with drug-resistant epilepsy and a left-sided Port-a-Cath positioned in the left internal jugular vein underwent uneventful insertion of a right-sided vagus nerve stimulator device.

The vagus nerve stimulator was deactivated due to postoperative cardiac side effects, which subsequently resolved.

We report the first case of a child with drug resistant epilepsy in whom a right-sided vagus nerve stimulator was deactivated due to postoperative cardiac effects. Nonetheless, right-sided implantation may be a viable therapeutic option when left-sided implantation is contraindicated, provided careful cardiac monitoring and individualized risk–benefit analysis are undertaken.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval by the local Ethics Committee was not necessary.

The patient's parents have consented to submission of this case report.

Received: 21 July 2025

Accepted after revision: 26 March 2026

Article published online:
16 June 2026

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