Vagal nerve stimulator complication: Difference between revisions
ClaireLewis (talk | contribs) No edit summary |
ClaireLewis (talk | contribs) |
||
| Line 18: | Line 18: | ||
*Outbursts of laughter | *Outbursts of laughter | ||
===Complications<ref>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.</ref>=== | ===Complications<ref>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.</ref>=== | ||
*Superficial skin | *Superficial [[skin infection]] | ||
*Deep space infection (e.g. [[retropharyngeal abscess]], [[Ludwig's angina]] | *Deep space infection (e.g. [[retropharyngeal abscess]], [[Ludwig's angina]] | ||
*Vocal cord paralysis | *Vocal cord paralysis | ||
*Contraction of supraglottic structures--> [[stridor]], sleep apnea | *Contraction of supraglottic structures--> [[stridor]], sleep apnea | ||
*Facial muscle paresis | *Facial muscle paresis | ||
*Cardiac arrhythmia (rare, as usually left vagus is stimulated) | *Cardiac [[arrhythmia]] (rare, as usually left vagus is stimulated) | ||
*Lead fracture | *Lead fracture | ||
**[[Twiddler syndrome]]: repeated (often subconscious) manipulation of device, can lead to lead fracture or other device malfunction | **[[Twiddler's syndrome]]: repeated (often subconscious) manipulation of device, can lead to lead fracture or other device malfunction | ||
==Evaluation== | ==Evaluation== | ||
Revision as of 23:25, 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 infection
- 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's 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.