Airway compromise secondary to vagus nerve stimulator: case report and implications for otolaryngologists

2009 ◽  
Vol 124 (5) ◽  
pp. 557-559 ◽  
Author(s):  
Y M Bhatt ◽  
P S Hans ◽  
A Belloso
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Vocal Fold ◽  
Airway Compromise ◽  
Nerve Stimulator ◽  
Vagus Nerve Stimulator ◽  
Vocal Fold Palsy

AbstractIntroduction:Vagus nerve stimulators are devices used in the management of patients with drug-refractory epilepsy unsuitable for resective or disconnective surgery. Implanted usually by neurosurgeons, these devices are infrequently encountered by otolaryngologists. Despite significant anti-seizure efficacy, side effects related to laryngopharyngeal stimulation are not uncommon.Case report:A 28-year-old man with a history of effective vagus nerve stimulator use presented with a cluster of seizures and respiratory distress associated with intermittent stridor. The duration of stridor corresponded to the period of vagus nerve stimulation. Endoscopy revealed forced adduction of the left vocal fold against a medialised right vocal fold. The device was switched off and the stridor immediately resolved.Conclusion:Airway compromise is an under-recognised side effect of vagus nerve stimulation. We describe the first known case of stridor and contralateral vocal fold palsy in a vagus nerve stimulator user. We highlight the need for better understanding amongst otolaryngologists of the laryngopharyngeal side effects of this technology.

scholarly journals Forbedring av rutiner rundt pasienter med vagusnervestimulator

2015 ◽  
Vol 10 (2) ◽  
pp. 151
Author(s):  
Christine Tørris ◽  
Kari Helen Schøyen ◽  
Elin Merete Wiklund
Keyword(s):  
Vagus Nerve ◽  
Antiepileptic Drugs ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Additional Dose ◽  
Nerve Stimulator ◽  
Vagus Nerve Stimulator ◽  
Before And After ◽  
Storage Area ◽  
And Storage

<p>Improving routines for patients with vagus nerve stimulation</p><p>Background: Vagus Nerve Stimulator (VNS) is a form of therapy which may reduce the frequency of seizures in people with epilepsy, who do not achieve remission with antiepileptic drugs. A corresponding magnet providing an additional dose of stimulation may stop or shorten the intensity of the seizure.</p><p>Objective Investigate the practice and procedure regarding use and storage of a VNS Therapy magnet, to see whether introduction of a new routine with a permanent seat for VNS magnet may contribute to increased availability of the magnet.</p><p>Method Registration of the magnets location was performed before, and after the magnetic board intervention. In addition staff answered a questionnaire related to experiences around storage of magnet.</p><p>Results The number of not located magnets dropped from 70% to 25 % after the intervention.</p><p>Conclusion A magnetic board as a storage area for VNS magnet on the patient's room increases the availability of the magnet.</p>

Early Implantation as a Main Predictor of Response to Vagus Nerve Stimulation in Childhood-Onset Refractory Epilepsy

2020 ◽  
pp. 088307382097485
Author(s):  
Angelo Russo ◽  
Ann Hyslop ◽  
Valentina Gentile ◽  
Daniela Chiarello ◽  
Tullio Messana ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Favorable Outcome ◽  
Nerve Stimulator ◽  
Seizure Onset ◽  
Vagus Nerve Stimulator ◽  
Favorable Clinical Outcome

Objective: We describe a multicenter experience with vagus nerve stimulator implantation in pediatric patients with drug-resistant epilepsy. Our goal was to assess vagus nerve stimulation efficacy and identify potential predictors of favorable outcome. Methods: This is a retrospective study. Inclusion criteria: ≤18 years at time of vagus nerve stimulator implantation, at least 1 year of follow-up. All patients were previously found to be unsuitable for an excisional procedure. Favorable clinical outcome and effective vagus nerve stimulation therapy were defined as seizure reduction >50%. Outcome data were reviewed at 1, 2, 3, and 5 years after vagus nerve stimulator implantation. Fisher exact test and multiple logistic regression analysis were employed. Results: Eighty-nine patients met inclusion criteria. Responder rate (seizure frequency reduction >50%) at 1-year follow-up was 25.8% (4.5% seizure-free). At last follow-up, 31.5% had a favorable outcome and 5.2% were seizure free. The only factor significantly predicting favorable outcome was time to vagus nerve stimulator implantation, with the best outcome achieved when vagus nerve stimulator implantation was performed within 3 years of seizure onset. Implantation between 3 and 5 years after epilepsy onset correlated with better long-term seizure freedom (13.3% at T5). Overall, 65.2% of patients evidenced improved quality of life at last follow-up. However, 12.4% had adverse events, but most were mild and disappeared after 3-4 months. Conclusions: Early vagus nerve stimulator implantation within 5 years of seizure onset was the only predictor of favorable clinical outcome in pediatric patients. Improved quality of life and a low incidence of significant adverse events were observed.

Vagus nerve stimulation: quality control in thyroid and parathyroid surgery

2000 ◽  
Vol 114 (2) ◽  
pp. 125-127 ◽  
Author(s):  
A. W. Lambert ◽  
C. Cosgrove ◽  
J. Barwell ◽  
S. Oxenham ◽  
D. C. Wilkins
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Vocal Fold ◽  
Contralateral Side ◽  
Equipment Failure ◽  
Parathyroid Surgery ◽  
Initial Identification ◽  
Vocal Fold Palsy ◽  
Stimulation Of

This paper describes the use of the Neurosign 100 Nerve Monitor and vagus nerve stimulation in the identification and assessment of the integrity of the recurrent laryngeal nerve (RLN) during thyroid and parathyroid surgery.Vocal fold function was assessed pre- and post-operatively in all patients undergoing thyroid and parathyroid surgery. The nerve monitor, used in association with endotracheal electrodes, was used to confirm correct RLN identification and demonstrate its integrity at the completion of surgery.There were 21 unilateral and 19 bilateral neck explorations. In these 40 patients, 57 of 59 RLNs were identified. The nerve monitor demonstrated RLN continuity in all but one case (equipment failure: electrode misplacement) after initial identification. Vagus nerve stimulation was performed in 21 patients without adverse sequelae. Damage to the RLN was identified in one of these patients, in whom direct RLN stimulation close to the larynx had failed to indicate discontinuity. Post-operatively this patient had a transient unilateral vocal fold palsy.The use of the Neurosign 100 Nerve Monitor is no substitute for meticulous surgery. Stimulation of the vagus nerve may be a more sensitive means of assessing RLN integrity during thyroid and parathyroid surgery than stimulation of the RLN itself. Confirmation of RLN integrity allows the surgeon to proceed with confidence to the contralateral side of the neck during hazardous bilateral explorations.

Cognition-enhancing effect of vagus nerve stimulation on refractory epilepsy secondary to lissencephaly: A case report.

2018 ◽  
Vol 11 (1) ◽  
pp. 80-85
Author(s):  
Rodrigo Marmo da Costa e Souza ◽  
Felipe Ricardo Pereira Vasconcelos De Arruda ◽  
Jose Anderson Galdino Santos ◽  
Jamerson De Carvalho Andrade ◽  
Suellen Mary Marinho Dos Santos Andrade ◽  
...  
Keyword(s):  
Case Report ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Refractory Epilepsy ◽  
Enhancing Effect

Implanted vagus nerve stimulation in 126 patients: surgical technique and complications

2020 ◽  
Vol 99 (7) ◽  
Keyword(s):  
Vagus Nerve ◽  
Vocal Cord ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Pulse Generator ◽  
Operative Procedure ◽  
Intractable Epilepsy ◽  
Vagal Nerve ◽  
University Hospital ◽  
Nerve Stimulator

Introduction: Vagus nerve stimulation is a palliative treatment for patients with refractory epilepsy to reduce the frequency and intensity of seizures. A bipolar helical electrode is placed around the left vagus nerve at the cervical level and is connected to the pulse generator placed in a subcutaneous pocket, most commonly in the subclavian region. Methods: Between March 1998 and October 2019, we performed 196 procedures related to the vagal nerve stimulation at the Neurosurgery Department in Motol University Hospital. Of these, 126 patients were vagal nerve stimulator implantation surgeries for intractable epilepsy. The cases included 69 female and 57 male patients with mean age at the time of the implantation surgery 22±12.4 years (range 2.1−58.4 years). Results: Nine patients (7.1%) were afflicted by complications related to implantation. Surgical complications included postoperative infection in 1.6%, VNS-associated arrhythmias in 1.6%, jugular vein bleeding in 0.8% and vocal cord paresis in 2.4%. One patient with vocal cord palsy also suffered from severe dysphagia. One patient (0.8%) did not tolerate extra stimulation with magnet due to a prolonged spasm in his throat. The extra added benefit of vagus stimulation in one patient was a significant reduction of previously regular severe headaches. Conclusion: Vagus nerve stimulation is an appropriate treatment for patients with drug-resistant epilepsy who are not candidates for focal resective surgery. Implantation of the vagus nerve stimulator is a relatively safe operative procedure.

Long Term Effects of Low Frequency (10 Hz) Vagus Nerve Stimulation on EEG and Heart Rate Variability in Crohn's Disease: A Case Report

2014 ◽  
Vol 7 (6) ◽  
pp. 914-916 ◽  
Author(s):  
Didier Clarençon ◽  
Sonia Pellissier ◽  
Valérie Sinniger ◽  
Astrid Kibleur ◽  
Dominique Hoffman ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Crohn’S Disease ◽  
Case Report ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Low Frequency ◽  
Long Term Effects

scholarly journals A case report of Vagus nerve stimulation for intractable hiccups

2021 ◽  
Vol 78 ◽  
pp. 219-222
Author(s):  
Kanza Tariq ◽  
Joe M. Das ◽  
Sasha Monaghan ◽  
Anna Miserocchi ◽  
Andrew McEvoy
Keyword(s):  
Case Report ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Intractable Hiccups
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