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We report a case of drug-resistant epilepsy with bilateral frontal lobe seizure onset, treated with left cervical VNS. Preoperative video- electroencephalogram revealed predominant interictal discharges in the right hemisphere and frequent seizures from both hemispheres. Following VNS, overall seizure frequency decreased. Notably, stereo-electroencephalography performed 15\u00a0months postoperatively showed a marked reduction in right-sided seizures, while left-sided seizures remained frequent. This case highlights the potential lateralized effect of VNS in a single patient with bilateral frontal lobe epilepsy, suggesting that VNS may preferentially suppress seizures originating from the right hemisphere.<\/jats:p>","DOI":"10.1007\/s00701-025-06653-x","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T09:21:56Z","timestamp":1756200116000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Asymmetric efficacy of VNS within a single patient with bilateral focal frontal lobe epilepsy: A case report"],"prefix":"10.1007","volume":"167","author":[{"given":"Masanobu","family":"Kumon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Nakae","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daijiro","family":"Kojima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noeru","family":"Kawase","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichi","family":"Hirose","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"issue":"4","key":"6653_CR1","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1097\/WNP.0b013e318227333a","volume":"28","author":"AZ Burakgazi","year":"2011","unstructured":"Burakgazi AZ, Burakgazi-Dalkilic E, Caputy AJ, Potolicchio SJ (2011) The correlation between vagus nerve stimulation efficacy and partial onset epilepsies. 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