title: Adverse Effects and Surgical Complications in Pediatric Patients Undergoing Vagal Nerve Stimulation for Drug-Resistant Epilepsy.
abstract: Vagal nerve stimulation (VNS) is an effective treatment for drug-resistant epilepsy that is not suitable for resective surgery, both in adults and in children. Few reports describe the adverse effects and complications of VNS. The aim of our study was to present a series of 33 pediatric patients who underwent VNS for drug-resistant epilepsy and to discuss the adverse effects and complications through a review of the literature.The adverse effects of VNS are usually transient and are dependent on stimulation of the vagus and its efferent fibers; surgical complications of the procedure may be challenging and patients sometimes require further surgery; generally these complications affect VNS efficacy; in addition, hardware complications also have to be taken into account.In our experience and according to the literature, adverse effects and surgical and hardware complications are uncommon and can usually be managed definitely. Careful selection of patients, particularly from a respiratory and cardiac point of view, has to be done before surgery to limit the incidence of some adverse effects.
authors.affiliation: Neurosurgery, Department of Surgery and Translational Medicine, Milan Center for Neuroscience, San Gerardo Hospital, University of Milano Bicocca, via Pergolesi 33, 20900, Monza, Italy. andrea.trezza@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Trezza
authors.affiliation: Neurosurgery, Department of Surgery and Translational Medicine, Milan Center for Neuroscience, San Gerardo Hospital, University of Milano Bicocca, via Pergolesi 33, 20900, Monza, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Landi
authors.affiliation: Unit of Pediatric Neurophysiology, Child Neuropsychiatric Clinic, San Gerardo Hospital, University of Milano Bicocca, via Pergolesi 33, 20900, Monza, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Grioni
authors.affiliation: Neurosurgery, Department of Surgery and Translational Medicine, Milan Center for Neuroscience, San Gerardo Hospital, University of Milano Bicocca, via Pergolesi 33, 20900, Monza, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Pirillo
authors.affiliation: Neurosurgery, Department of Surgery and Translational Medicine, Milan Center for Neuroscience, San Gerardo Hospital, University of Milano Bicocca, via Pergolesi 33, 20900, Monza, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Fiori
authors.affiliation: Neurosurgery, Department of Surgery and Translational Medicine, Milan Center for Neuroscience, San Gerardo Hospital, University of Milano Bicocca, via Pergolesi 33, 20900, Monza, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Giussani
authors.affiliation: Neurosurgery, Department of Surgery and Translational Medicine, Milan Center for Neuroscience, San Gerardo Hospital, University of Milano Bicocca, via Pergolesi 33, 20900, Monza, Italy.
authors.forename: E P
authors.initials: EP
authors.lastname: Sganzerla
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000209:etiology; D000069279:Drug Resistant Epilepsy / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007627:Keloid / Q000453:epidemiology; D008297:Male; D009325:Nausea / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology; D019919:Prosthesis Implantation; D013897:Thoracic Duct / Q000293:injuries; D055536:Vagus Nerve Stimulation / Q000009:adverse effects / Q000379:methods*; D014839:Vomiting / Q000209:etiology
chemical_list: D000927:Anticonvulsants
keywords: Complications; Drug-resistant epilepsy; Pediatric age; Vagal nerve stimulation