Vagal nerve stimulator complication: Difference between revisions
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==Background== | ==Background== | ||
[[File:VagusStimulator.jpg|thumb]] | |||
*Used to treat refractory [[epilepsy]] | *Used to treat refractory [[epilepsy]] | ||
*Pulse generator implanted in chest, electric lead attached to vagus nerve in neck | *Pulse generator implanted in chest, electric lead attached to vagus nerve in neck | ||
*Generator stimulates vagal nerve at regular intervals | *Generator stimulates vagal nerve at regular intervals | ||
**Usually does NOT stimulate right vagus nerve (which innervates heart) | **Usually does NOT stimulate right vagus nerve (which innervates heart) | ||
*Magnet over VNS leads to extra stimulation | *Magnet over VNS leads to extra stimulation | ||
**Patients/caregivers may use magnet in case of aura or breakthrough seizure | |||
==Complications== | ==Complications== | ||
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*Hoarseness, [[cough]], [[sore throat]] | *Hoarseness, [[cough]], [[sore throat]] | ||
*Drooling, dysphagia | *Drooling, dysphagia | ||
* | *Torticolis/neck spasms | ||
*Anorexia | *Anorexia | ||
*Shoulder abduction | *Shoulder abduction | ||
Revision as of 23:24, 23 October 2016
Background
- Used to treat refractory epilepsy
- Pulse generator implanted in chest, electric lead attached to vagus nerve in neck
- Generator stimulates vagal nerve at regular intervals
- Usually does NOT stimulate right vagus nerve (which innervates heart)
- Magnet over VNS leads to extra stimulation
- Patients/caregivers may use magnet in case of aura or breakthrough seizure
Complications
Side Effects[1]
- Hoarseness, cough, sore throat
- Drooling, dysphagia
- Torticolis/neck spasms
- Anorexia
- Shoulder abduction
- Urinary retention
- Outbursts of laughter
Complications[2]
- Superficial skin infections
- Deep space infection (e.g. retropharyngeal abscess, Ludwig's angina
- Vocal cord paralysis
- Contraction of supraglottic structures--> stridor, sleep apnea
- Facial muscle paresis
- Cardiac arrhythmia (rare, as usually left vagus is stimulated)
- Lead fracture
- Twiddler syndrome: repeated (often subconscious) manipulation of device, can lead to lead fracture or other device malfunction
Evaluation
Management
Disposition
See Also
External Links
References
- ↑ Serdaroglu A, Arhan E, Kurt G, et al. Long term effect of vagus nerve stimulation in pediatric intractable epilepsy: an extended follow-up. Childs Nerv Syst. 2016;32(4):641-6.
- ↑ Smyth MD, Tubbs RS, Bebin EM, Grabb PA, Blount JP. Complications of chronic vagus nerve stimulation for epilepsy in children. J Neurosurg. 2003;99(3):500-3.