title: Complications of vagal nerve stimulation for epilepsy in children.
abstract: Vagal nerve stimulation (VNS) is a surgical option to treat drug-resistant epilepsy. A few side effects have been described, mainly as anecdotal reports. We analysed our material concerning a juvenile population to identify the most common and most important complications, discussing them with the literature. Thirty-six patients were studied (18 months-18 years old). The children were assessed before the VNS implant and 3, 6, 12, 24 and 36 months after surgery. The mean follow-up was 30 months. Four patients required a second surgery: two for changing the device 3 years after implant; one for revision of an imperfect implant; one for removing a non-functioning device. In one patient a transient vocal cord paralysis was observed. Hoarseness was the main complaint (38.8%). More infrequent was mild sleep apnoea (8.3%), sternocleidomastoid muscle spasm, drooling and snoring in one patient each. Skin scars were reported with a different frequency according to the surgical technique. At variance with the literature reports, we did not observe infections. Side effects of VNS can be minimised, but not avoided completely, with a correct technical procedure, which in turn depends upon a thorough knowledge of vagus nerve anatomy.
authors.affiliation: Neurosurgical Department, Ospedali Riuniti Umberto I-GM Lancisi-G. Salesi, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Rychlicki
authors.forename: N
authors.initials: N
authors.lastname: Zamponi
authors.forename: E
authors.initials: E
authors.lastname: Cesaroni
authors.forename: L
authors.initials: L
authors.lastname: Corpaci
authors.forename: R
authors.initials: R
authors.lastname: Trignani
authors.forename: A
authors.initials: A
authors.lastname: Ducati
authors.forename: M
authors.initials: M
authors.lastname: Scerrati
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D004567:Electrodes, Implanted; D004827:Epilepsy / Q000503:physiopathology / Q000628:therapy*; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008134:Long-Term Care; D008297:Male; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000503:physiopathology*