Status Epilepticus Treated With Vagus Nerve Stimulation in an Adult With Cortical Dysplasia: A Case Report

Status epilepticus (SE) is a neurological emergency characterized by prolonged seizures, with significant risks of neuronal injury and mortality. This case presents a 60-year-old man with drug-resistant epilepsy and a history of recurrent prolonged seizures. His seizures began in early childhood and persisted despite multiple anti-seizure medications. Notably, his semiology included the chapeau de gendarme sign, suggesting an involvement of the anterior cingulate cortex and frontal lobe. Brain MRI revealed a cortical dysplasia in the right inferior frontal gyrus. Given his high risk of sudden unexpected death in epilepsy (SUDEP) due to frequent generalized tonic-clonic seizures, vagus nerve stimulation (VNS) was considered an alternative therapy, with future evaluation for a surgical intervention involving lesionectomy. Following VNS implantation, his SE was arrested with standard titration, and within six months, the patient achieved seizure freedom. This case demonstrates the use of VNS in controlling SE. Further research is necessary to determine optimal protocols for VNS use in SE.