caa a22 4500 463181328 CHVBK 20180406164840.0 cr unu---uuuuu 170326e20071101xx s 000 0 eng 10.1007/s00381-007-0404-8 doi (NATIONALLICENCE)springer-10.1007/s00381-007-0404-8 Vagus nerve stimulation in children with refractory epilepsy: unusual complications and relationship to sleep-disordered breathing [Elektronische Daten] [Divya Khurana, Marko Reumann, Elizabeth Hobdell, Samuel Neff, Ignacio Valencia, Agustin Legido, Sanjeev Kothare] Background: Vagus nerve stimulation (VNS) is approved for use in patients with refractory epilepsy over the age of 12years. While this procedure is widely used, there is little data on adverse events in young children. Materials and methods: A retrospective chart review was conducted on 26 children who had VNS implantation for refractory epilepsy from 1998 to 2004. Results: Ages ranged from 3 to 17years (16 boys and 10 girls). Seventy-seven percent had moderate to severe mental retardation. Sixty-five percent had more than 30 seizures per month. Symptomatic-generalized epilepsy was the predominant epilepsy syndrome seen in 77% of children. The duration of VNS treatment ranged from 1month to 8years (mean = 3.5years). Twenty of 26 patients (77%) were on rapid-cycling mode. More than 50% reduction in seizure frequency was noted in 54% with two patients achieving seizure freedom. Twenty-three percent had less than 50% seizure reduction. Four patients were able to terminate seizures with use of the magnet. VNS was removed from one patient because of intractable cough persisting in spite of stimulation being turned off for 1month. Another patient had it removed twice for infection. Obstructive sleep apnea (OSA) was observed in four patients (15%) after placement of VNS. Conclusion: VNS appears to be an effective treatment for children with refractory epilepsy. Development of intractable cough in one patient in spite of device being turned off and recurrent infection-related removal in another are unusual complications. Polysomnography before implantation of VNS should be considered to identify patients with pre-existing OSA. Springer-Verlag, 2007 Vagus nerve stimulation nationallicence Children nationallicence Epilepsy nationallicence Sleep apnea nationallicence Khurana Divya Section of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, 19134, Philadelphia, PA, USA aut Reumann Marko Section of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, 19134, Philadelphia, PA, USA aut Hobdell Elizabeth Section of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, 19134, Philadelphia, PA, USA aut Neff Samuel Section of Neurosurgery, St. Christopher's Hospital for Children, Drexel University College of Medicine, 19134, Philadelphia, PA, USA aut Valencia Ignacio Section of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, 19134, Philadelphia, PA, USA aut Legido Agustin Section of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, 19134, Philadelphia, PA, USA aut Kothare Sanjeev Section of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, 19134, Philadelphia, PA, USA aut Child's Nervous System Springer-Verlag 23/11(2007-11-01), 1309-1312 0256-7040 23:11<1309 2007 23 381 https://doi.org/10.1007/s00381-007-0404-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-007-0404-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Khurana Divya Section of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, 19134, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Reumann Marko Section of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, 19134, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Hobdell Elizabeth Section of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, 19134, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Neff Samuel Section of Neurosurgery, St. Christopher's Hospital for Children, Drexel University College of Medicine, 19134, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Valencia Ignacio Section of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, 19134, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Legido Agustin Section of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, 19134, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Kothare Sanjeev Section of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, 19134, Philadelphia, PA, USA aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/11(2007-11-01), 1309-1312 0256-7040 23:11<1309 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer