Skip to main content
SpringerLink
Log in

Adverse Effects and Surgical Complications in Pediatric Patients Undergoing Vagal Nerve Stimulation for Drug-Resistant Epilepsy

  • Conference paper
Trends in Reconstructive Neurosurgery

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 124))

Abstract

Vagal nerve stimulation (VNS) is an effective treatment for drug-resistant epilepsy that is not suitable for resective surgery, both in adults and in children. Few reports describe the adverse effects and complications of VNS. The aim of our study was to present a series of 33 pediatric patients who underwent VNS for drug-resistant epilepsy and to discuss the adverse effects and complications through a review of the literature.

The adverse effects of VNS are usually transient and are dependent on stimulation of the vagus and its efferent fibers; surgical complications of the procedure may be challenging and patients sometimes require further surgery; generally these complications affect VNS efficacy; in addition, hardware complications also have to be taken into account.

In our experience and according to the literature, adverse effects and surgical and hardware complications are uncommon and can usually be managed definitely. Careful selection of patients, particularly from a respiratory and cardiac point of view, has to be done before surgery to limit the incidence of some adverse effects.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Alexopoulos AV, Kotagal P, Loddenkemper T, Hammel J, Bingaman WE (2006) Long- term results with vagus nerve stimulation in children with pharmacoresistant epilepsy. Seizure 15:491–503

    Article  PubMed  Google Scholar 

  2. Ardesch JJ, Buschman HP, Wagener-Schimmel LJ, van der Aa HE, Hageman G (2007) Vagus nerve stimulation for medically refractory epilepsy: a long-term follow-up study. Seizure 16(7):579–585

    Article  CAS  PubMed  Google Scholar 

  3. Asconapé J, Moore D, Zipes D, Hartmann L, Duffel WH (1999) Bradycardia and asystole with the use of vagus nerve stimulation the treatment of epilepsy: a rare complication of intra- operative device testing. Epilepsia 40:1452–1454

    Article  PubMed  Google Scholar 

  4. Ben-Menachem E (2002) Vagus nerve stimulation for the treatment of epilepsy. Lancet Neurol 1:477–482

    Article  PubMed  Google Scholar 

  5. Berg AT, Zelko FA, Levy SR, Testa FM (2012) Age at onset of epilepsy, pharmacoresistance, and cognitive outcomes: a prospective cohort study. Neurology 79:1384–1391

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Coykendall DS, Gauderer MW, Blouin BB, Morales A (2010) Vagus nerve stimulation for the management of seizures in children: an 8 year experience. J Pediatr Surg 45:1479–1483

    Article  PubMed  Google Scholar 

  7. Dlouhy BJ, Viljoen SV, Kung DK, Vogel TW, Granner MA, Howard MA, Kawasaki H (2012) Vagus nerve stimulation after lead revision. Neurosurg Focus 32(3):E11

    Article  PubMed  Google Scholar 

  8. Elliott RE, Rodgers SD, Bassani L, Morsi A, Geller EB, Carlson C, Devinsky O, Doyle WK (2011) Vagus nerve stimulation for children with treatment-resistant epilepsy: a consecutive series of 141 cases. J Neurosurg Pediatr 7:491–500

    Article  PubMed  Google Scholar 

  9. Espinosa J, Aiello MT, Naritoku DK (1999) Revision and removal of stimulating electrodes following long-term therapy with the vagus nerve stimulator. Surg Neurol 51:659–664

    Article  CAS  PubMed  Google Scholar 

  10. Hatton KW, McLarney JT, Pittman T, Fahy BG (2006) Vagal nerve stimulation: overview and implications for anesthesiologists. Anesth Analg 103:1241–1249

    Article  PubMed  Google Scholar 

  11. Huf RL, Mamelak A, Kneedy-Cayem K (2005) Vagus nerve stimulation therapy: 2-year prospective open-label study of 40 subjects with refractory epilepsy and low IQ who are living in long-term care facilities. Epilepsy Behav 6:417–423

    Article  PubMed  Google Scholar 

  12. Kahlow H, Olivecrona M (2013) Complications of vagal nerve stimulation for drug-resistant epilepsy: a single center longitudinal study of 143 patients. Seizure 22:827–833

    Article  PubMed  Google Scholar 

  13. Kang HC, Hwang YS, Kim DS, Kim HD (2006) Vagus nerve stimulation in pediatric intractable epilepsy: a Korean bicentric study. Acta Neurochir Suppl 99:93–96

    Article  CAS  PubMed  Google Scholar 

  14. Kuba R, Brazdil M, Kalina M, Prochazka T, Hovorka J, Nezadal T, Hadac J, Brozova K, Sebronova V, Komarek V, Marusic P, Oslejskova H, Zarubova J, Rektor I (2009) Vagus nerve stimulation: longitudinal follow-up of patients treated for 5 years. Seizure 18:269–274

    Article  PubMed  Google Scholar 

  15. Kwan P, Arzimanoglou A, Berg AT, Brodie MJ, Allen Hauser W, Mathern G, Moshé SL, Perucca E, Wiebe S, French J (2010) Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 51:1069–1077

    Article  CAS  PubMed  Google Scholar 

  16. Kwan P, Schachter SC, Brodie MJ (2011) Drug-resistant epilepsy. N Engl J Med 365:919–926

    Article  CAS  PubMed  Google Scholar 

  17. Landy HJ, Ramsay RE, Slater J, Casiano RR, Morgan R (1993) Vagus nerve stimulation for complex partial seizures: surgical technique, safety, and efficacy. J Neurosurg 78:26–31

    Article  CAS  PubMed  Google Scholar 

  18. MacDonald J, Couldwell WT (2004) Revision of vagal nerve stimulator electrodes: technical approach. Acta Neurochir 146:567–570

    Article  CAS  PubMed  Google Scholar 

  19. Morris GL, Mueller WM (1999) Long-term treatment with vagus nerve stimulation in patients with refractory epilepsy. The Vagus Nerve Stimulation Study Group E01-E05. Neurology 53:1731–1735

    Article  PubMed  Google Scholar 

  20. Ng WH, Donner E, Go C, Abou-Hamden A, Rutka JT (2010) Revision of vagal nerve stimulation (VNS) electrodes: review and report on use of ultra-sharp monopolar tip. Childs Nerv Syst 26:1081–1084

    Article  PubMed  Google Scholar 

  21. Orosz I, McCormick D, Zamponi N, Varadkar S, Feucht M, Parain D, Griens R, Vallee L, Boon P, Rittey C, Jayewardene AK, Bunker M, Arzimanoglou A, Lagae L (2014) Vagus nerve stimulation for drug-resistant epilepsy: a European long-term study up to 24 months in 347 children. Epilepsia 55(10):1576–1584

    Article  PubMed  Google Scholar 

  22. Parhizgar F, Nugent K, Raj R (2011) Obstructive sleep apnea and respiratory complications associated with vagus nerve stimulators. J Clin Sleep Med 7(4):401–407

    PubMed  PubMed Central  Google Scholar 

  23. Patwardhan RV, Stong B, Bebin EM, Mathisen J, Grabb PA (2000) Efficacy of vagal nerve stimulation in children with medically refractory epilepsy. Neurosurgery 47:1353–1357

    Article  CAS  PubMed  Google Scholar 

  24. Rychlicki F, Zamponi N, Cesaroni E, Corpaci L, Trignani R, Ducati A, Scerrati M (2006) Complications of vagal nerve stimulation for epilepsy in children. Neurosurg Rev 29:103–107

    Article  CAS  PubMed  Google Scholar 

  25. Smyth MD, Tubbs RS, Bebin EM, Grabb PA, Blount JP (2003) Complications of chronic vagus nerve stimulation for epilepsy in children. J Neurosurg 99:500–503

    Article  PubMed  Google Scholar 

  26. Spuck S, Tronnier V, Orosz I, Schönweiler R, Sepehrnia A, Nowak G, Sperner J (2010) Operative and technical complications of vagus nerve stimulator implantation. Neurosurgery 67:489–494

    PubMed  Google Scholar 

  27. Vassilyadi M, Strawsburg RH (2003) Delayed onset of vocal cord paralysis after explantation of a vagus nerve stimulator in a child. Childs Nerv Syst 19:261–263

    CAS  PubMed  Google Scholar 

Download references

Conflict of Interest Statement

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Neurosurgery, Department of Surgery and Translational Medicine, Milan Center for Neuroscience, San Gerardo Hospital, University of Milano Bicocca, via Pergolesi 33, 20900, Monza, Italy

    A. Trezza MD, A. Landi MD, D. Pirillo MD, L. Fiori MD, C. Giussani MD, PhD & E. P. Sganzerla

  2. Unit of Pediatric Neurophysiology, Child Neuropsychiatric Clinic, San Gerardo Hospital, University of Milano Bicocca, via Pergolesi 33, 20900, Monza, Italy

    D. Grioni MD

Authors
  1. A. Trezza MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Landi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Grioni MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D. Pirillo MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. Fiori MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C. Giussani MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. E. P. Sganzerla
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Trezza MD .

Editor information

Editors and Affiliations

  1. Institute of Neurosurgery Medical School, Catholic University of Rome, Rome, Italy

    Massimiliano Visocchi

  2. Dept. of Neurosurgery, Christian-Albrechts-University of Kiel, Kiel, Germany

    H. Maximilian Mehdorn

  3. Department of Neurological Surgery, Nihon University, Tokyo, Japan

    Yoichi Katayama

  4. Medical Faculty University of Münster, Münster, Germany

    Klaus R. H. von Wild

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this paper

Cite this paper

Trezza, A. et al. (2017). Adverse Effects and Surgical Complications in Pediatric Patients Undergoing Vagal Nerve Stimulation for Drug-Resistant Epilepsy. In: Visocchi, M., Mehdorn, H.M., Katayama, Y., von Wild, K.R.H. (eds) Trends in Reconstructive Neurosurgery. Acta Neurochirurgica Supplement, vol 124. Springer, Cham. https://doi.org/10.1007/978-3-319-39546-3_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-39546-3_7

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-39545-6

  • Online ISBN: 978-3-319-39546-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation