Diferencia entre revisiones de «Vagal nerve stimulator complication»

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*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
**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


*Implanted in the chest with a single lead stimulating the left vagus nerve. It does not stimulate the right vagus nerve which innervates the heart
==Complications==
 
===Side Effects<ref>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.</ref>===
==Clinical Features==
*Hoarseness, [[cough]], [[sore throat]]
 
*Drooling, dysphagia
==Differential Diagnosis==
*[[Torticolis]]/neck spasms
Complications:
*Anorexia
*Hoarseness
*Shoulder abduction
*Shortness of Breath
*[[Urinary retention]]
*Pharyngitis
*Outbursts of laughter
*Infection
===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>===
*Parasthesias
*Superficial skin infections
*Insomnia
*Deep space infection (e.g. [[retropharyngeal abscess]], [[Ludwig's angina]]
*Excessive Pain
*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==
==Evaluation==
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==See Also==
==See Also==
*[[Medical device complications]]
*[[Medical device complications]]
*[[Seizure]]


==External Links==
==External Links==

Revisión del 23:22 23 oct 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

Complications

Side Effects[1]

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

  1. 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.
  2. 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.