M Vassilyadi1, R H Strawsburg. 1. Division of Neurosurgery and Neurology, Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA. vassilyadi@cheo.on.ca
Abstract
INTRODUCTION: Vagus nerve stimulation for the management of intractable seizure disorders is increasingly being used, especially in younger children. Although complications such as infection or vocal cord paralysis are uncommon, some may be unreported. CLINICAL PRESENTATION: A 3.5-year-old boy with intractable complex partial and generalized seizures had a left vagus nerve stimulator (VNS) successfully implanted. Two weeks later, the cervical incision showed signs of infection, antibiotics were started, and the VNS generator and leads were explanted. Three weeks later the child's mother noted a change in the voice of her son, as well as increased coughing and gagging. Flexible laryngoscopy identified a left vocal cord paralysis, which eventually resolved after 6 months. CONCLUSION: Infection requiring explantation of a VNS is uncommon. The risk is higher in younger children, especially in those who are developmentally delayed. These children may continuously drool, with saliva or food soiling the fresh incision, or even pick at the incision to the point of twisting or even pulling out the electrodes. Less common is a vocal cord paralysis, especially occurring in a delayed fashion.
INTRODUCTION: Vagus nerve stimulation for the management of intractable seizure disorders is increasingly being used, especially in younger children. Although complications such as infection or vocal cord paralysis are uncommon, some may be unreported. CLINICAL PRESENTATION: A 3.5-year-old boy with intractable complex partial and generalized seizures had a left vagus nerve stimulator (VNS) successfully implanted. Two weeks later, the cervical incision showed signs of infection, antibiotics were started, and the VNS generator and leads were explanted. Three weeks later the child's mother noted a change in the voice of her son, as well as increased coughing and gagging. Flexible laryngoscopy identified a left vocal cord paralysis, which eventually resolved after 6 months. CONCLUSION:Infection requiring explantation of a VNS is uncommon. The risk is higher in younger children, especially in those who are developmentally delayed. These children may continuously drool, with saliva or food soiling the fresh incision, or even pick at the incision to the point of twisting or even pulling out the electrodes. Less common is a vocal cord paralysis, especially occurring in a delayed fashion.
Authors: B M Uthman; B J Wilder; J K Penry; C Dean; R E Ramsay; S A Reid; E J Hammond; W B Tarver; J F Wernicke Journal: Neurology Date: 1993-07 Impact factor: 9.910
Authors: Vitaly Napadow; Robert R Edwards; Christine M Cahalan; George Mensing; Seth Greenbaum; Assia Valovska; Ang Li; Jieun Kim; Yumi Maeda; Kyungmo Park; Ajay D Wasan Journal: Pain Med Date: 2012-05-08 Impact factor: 3.750
Authors: Alice Noris; Paolo Roncon; Simone Peraio; Anna Zicca; Matteo Lenge; Andrea Di Rita; Lorenzo Genitori; Flavio Giordano Journal: J Neurosurg Case Lessons Date: 2021-07-19