PURPOSE: Vagus nerve stimulation (VNS) is reported to reduce the frequency of seizures in children and adults without causing serious side effects. However, clinical observation of swallowing difficulties in 2 children treated with VNS made further investigation necessary. METHODS: Seven patients aged 4-18 years and treated with VNS for 6-14 months were investigated with videoradiography during barium swallow. The children performed 5-30 barium swallow investigations with the VNS device turned off, running as programmed, or set at continuous stimulations. The degree of aspiration was scored from 0 to 3. RESULTS: In 5 of 7 children, of whom reported transient swallowing difficulties, no change in the degree of aspiration was noted. The 2 children with swallowing difficulties, however. showed increased aspiration score when the stimulator was set at continuous stimulations. In 1 the score also appeared to increase with the VNS running as programmed (p > 0.05). Both children had severe mental and motor disabilities. CONCLUSIONS: Before and during VNS treatment patients should be evaluated with regard to swallowing problems. There needs to be an easy way to turn the device on and off to avoid aspirations, a hazardous and potentially life-threatening complication of VNS.
PURPOSE: Vagus nerve stimulation (VNS) is reported to reduce the frequency of seizures in children and adults without causing serious side effects. However, clinical observation of swallowing difficulties in 2 children treated with VNS made further investigation necessary. METHODS: Seven patients aged 4-18 years and treated with VNS for 6-14 months were investigated with videoradiography during barium swallow. The children performed 5-30 barium swallow investigations with the VNS device turned off, running as programmed, or set at continuous stimulations. The degree of aspiration was scored from 0 to 3. RESULTS: In 5 of 7 children, of whom reported transient swallowing difficulties, no change in the degree of aspiration was noted. The 2 children with swallowing difficulties, however. showed increased aspiration score when the stimulator was set at continuous stimulations. In 1 the score also appeared to increase with the VNS running as programmed (p > 0.05). Both children had severe mental and motor disabilities. CONCLUSIONS: Before and during VNS treatment patients should be evaluated with regard to swallowing problems. There needs to be an easy way to turn the device on and off to avoid aspirations, a hazardous and potentially life-threatening complication of VNS.
Authors: Luca Castellani; Valentina Chiesa; Alberto Maccari; Emanuela Fuccillo; Maria Paola Canevini; Giovanni Felisati; Alberto Maria Saibene Journal: Clin Case Rep Date: 2020-02-26
Authors: Michelle G M H Florie; Walmari Pilz; Remco H Dijkman; Bernd Kremer; Anke Wiersma; Bjorn Winkens; Laura W J Baijens Journal: Dysphagia Date: 2020-05-14 Impact factor: 3.438