Vagal nerve stimulator complications
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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
- Torticollis/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.