Severe dysphagia caused by vagus nerve herpetic neuropathy: a case report

Purpose Severe dysphagia with weak pharyngeal peristalsis after dorsal lateral medullary infarction (LMI) requires long-term tube feeding. However, no study is currently available on therapeutic effectiveness in severe dysphagia caused by nuclear damage of vagus nerve after dorsal LMI. The purpose of the present investigation was to explore the potential of transcutaneous vagus nerve stimulation (tVNS) to improve severe dysphagia with weak pharyngeal peristalsis after dorsal LMI. Method We assessed the efficacy of 6-week tVNS in a 28-year-old woman presented with persisting severe dysphagia after dorsal LMI who had been on nasogastric feeding for 6 months. tVNS was applied for 20 min twice a day, 5 days a week, for 6 weeks. The outcome measures included saliva spitted, Swallow Function Scoring System, Functional Oral Intake Scale, Clinical Assessment of Dysphagia With Wallenberg Syndrome, Yale Pharyngeal Residue Severity Rating Scale, and upper esophagus X-ray examination. Results After tVNS, the patient was advanced to a full oral diet without head rotation or spitting. No saliva residue was found in the valleculae and pyriform sinuses. Contrast medium freely passed through the upper esophageal sphincter. Conclusion Our findings suggest that tVNS might provide a useful means for recovery of severe dysphagia with weak pharyngeal peristalsis after dorsal LMI. Supplemental Material https://doi.org/10.23641/asha.9755438

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

Psychology & Neuroscience ◽

10.1037/pne0000120 ◽

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

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Dysphagia following implantation of an vagus nerve stimulator - a case report

Neuropediatrics ◽

10.1055/s-0033-1337880 ◽

2013 ◽

Vol 44 (02) ◽

Author(s):

C Reutlinger ◽

D Mergardt ◽

C Maxton

Keyword(s):

Case Report ◽

Vagus Nerve ◽

Nerve Stimulator ◽

Vagus Nerve Stimulator

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Premalignant and Malignant Lesions of the Heterotopic Pancreas in the Esophagus: a Case Report and Review of the Literature

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.242.uly ◽

2015 ◽

Vol 24 (2) ◽

pp. 235-239 ◽

Cited By ~ 9

Author(s):

Jan Ulrych ◽

Vladimir Fryba ◽

Helena Skalova ◽

Zdenek Krska ◽

Tomas Krechler ◽

...

Keyword(s):

Case Report ◽

Gastrointestinal Tract ◽

Unusual Case ◽

Accurate Diagnosis ◽

Heterotopic Pancreas ◽

Premalignant Lesions ◽

Resected Specimen ◽

Review Of The Literature ◽

Severe Dysphagia ◽

Malignant Lesions

Heterotopic pancreas is a congenital pathology of the gastrointestinal tract, particularly rare in the esophagus. Both symptomatology and findings during preoperative examinations are non-specific and therefore do not often lead to an accurate diagnosis, which is usually revealed only by histopathological assessment of a resected specimen. We report an unusual case of a patient suffering from severe dysphagia caused by heterotopic pancreas in the distal esophagus with chronic inflammation and foci of premalignant changes. This article also reviews 14 adult cases of heterotopic pancreas in the esophagus previously reported in the literature, with the aim of determining the clinical features of this disease and possible complications including rare premalignant lesions and malignant transformation. Especially with regard to those complications, we suggest that both symptomatic and incidentally found asymptomatic lesions should be resected.

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

Brain Stimulation ◽

10.1016/j.brs.2014.08.001 ◽

2014 ◽

Vol 7 (6) ◽

pp. 914-916 ◽

Cited By ~ 26

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

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A case report of Vagus nerve stimulation for intractable hiccups

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2020.12.023 ◽

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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Isolated Dysphagia in a Patient with Medial Medullary Infarction – Effects of Evidence-Based Dysphagia Therapy: A Case Report

Case Reports in Neurology ◽

10.1159/000513676 ◽

2021 ◽

pp. 190-199

Author(s):

Samra Hamzic ◽

Patrick Schramm ◽

Hassan Khilan ◽

Tibo Gerriets ◽

Martin Juenemann

Keyword(s):

Case Report ◽

Vascular Occlusion ◽

Evidence Based ◽

Severe Dysphagia ◽

First Case ◽

Jaw Opening ◽

Medial Medullary Infarction ◽

Dysphagia Therapy ◽

Evidence Based Therapy ◽

Medullary Infarction

Medial medullary infarction (MMI) is a vascular occlusion in the medulla oblongata leading to certain constellations of neurological symptoms and seriously affecting the patient. Effective evidence-based treatment of severe dysphagia as sole symptom of MMI has not yet been reported. This case study aims to report successful effects of evidence-based therapy based on findings of dysphagia symptoms and pathophysiology of swallowing by flexible endoscopic evaluation of swallowing (FEES) in severe isolated dysphagia after MMI. FEES was performed to evaluate swallowing pathophysiology and dysphagia symptoms in a 57-year-old male with severe dysphagia after MMI. On the basis of FEES findings, simple and high-frequent evidence-based exercises for improvement of swallowing were implemented: thermal stimulation of faucial arches, Jaw Opening Exercise, and Jaw Opening Against Resistance. After 7 weeks of high-frequent evidence-based therapy and regular FEES evaluation the patient was set on full oral diet with no evidence of aspiration risk. In a first case report of isolated dysphagia in MMI our case illustrates that high-frequent evidence-based dysphagia therapy in combination with FEES as the method to evaluate and monitor swallowing pathophysiology can lead to successful and quick rehabilitation of severely affected dysphagic patients.

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