Background Neurological emergencies during pregnancy present unique challenges that require rapid, ethically sensitive decisions balancing maternal survival and fetal well‐being. Case Presentation We describe a 26‐year‐old pregnant woman with drug‐resistant focal epilepsy secondary to right frontal cortical dysplasia in 2022, treated initially with surgery. During her early pregnancy, she developed super‐refractory status epilepticus, unresponsive to multiple antiseizure drugs and anesthetics. Due to persistent seizures and hemodynamic instability, a vagus nerve stimulator was implanted. Within 24 h of activation, seizures ceased. Given a poor fetal prognosis due to systemic conditions, pregnancy termination was decided. The patient recovered without further seizures and was discharged on optimized therapy. Discussion This case illustrates the potential role of VNS as an emergent neuromodulatory treatment for SRSE in pregnancy. The ethical decisions highlight the complexities and need for multidisciplinary coordination with maternal‐fetal care. Conclusion Vagal nerve stimulation may serve as a life‐saving intervention in selected pregnant patients with SRSE. Ethical, clinical, and logistical factors must guide decision‐making in such rare but critical scenarios.
Camacho-Castillo et al. (2026) studied this question.