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Erin D'Agostino, Vyacheslav Makler, David F Bauer
BACKGROUND: Vagal nerve stimulation (VNS) is a safe and well-tolerated treatment for drug resistant epilepsy. Complications and failure of the device can result from lead fracture, device malfunction, disconnection, or battery displacement and can result in a variety of symptoms. We present an interesting case of stimulator malfunction with increased impedance change seen only with a change in head position. CASE DESCRIPTION: Patient is a 25-year-old male with a vagal nerve stimulator (VNs) placed for medically refractory epilepsy who presented with neck pain and an electrical pulling sensation in his neck whenever he turned his head to the right...
March 16, 2018: World Neurosurgery
Naoko Yamaguchi, Kentaro Yamakawa, Pradeep S Rajendran, Tatsuo Takamiya, Marmar Vaseghi
BACKGROUND: Neuraxial modulation with cardiac sympathetic denervation (CSD) can potentially reduce burden of ventricular tachy-arryhthmias (VT). Despite catheter ablation and CSD, however, VT can recur in patients with cardiomyopathy and the role of vagal nerve stimulation (VNS) in this setting is unclear. OBJECTIVE: The purpose of this study was to evaluate electrophysiological effects of VNS after CSD in normal and infarcted hearts. METHODS: In 10 normal and 6 infarcted pigs, electrophysiological and hemodynamic parameters were evaluated before and during intermittent VNS pre-CSD (bilateral stellectomy and T2-T4 thoracic ganglia removal) as well as post-CSD...
March 9, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Hong-Yun Liu, Zhao Yang, Fan-Gang Meng, Yu-Guang Guan, Yan-Shan Ma, Shu-Li Liang, Jiu-Luan Lin, Long-Sheng Pan, Ming-Ming Zhao, Wei Qu, Hong-Wei Hao, Guo-Ming Luan, Jian-Guo Zhang, Lu-Ming Li
Vagus nerve stimulation (VNS) is an adjunctive treatment for drug-resistant epilepsy (DRE). However, it is still difficult to predict which patients will respond to VNS treatment and to what extent. We aim to explore the relationship between preoperative heart rate variability (HRV) and VNS outcome. 50 healthy control subjects and 63 DRE patients who had received VNS implants and had at least one year of follow up were included. The preoperative HRV were analyzed by traditional linear methods and heart rhythm complexity analyses with multiscale entropy (MSE)...
March 1, 2018: Scientific Reports
Yirong Yang, Lisa Y Yang, Lilla Orban, Darnell Cuylear, Jeffrey Thompson, Bruce Simon, Yi Yang
BACKGROUND: Vagus nerve stimulation (VNS) significantly reduces infarct volume in rat models of cerebral ischemia, but the mechanism of this protective effect remains open. HYPOTHESIS: This study tested the hypothesis that non-invasive VNS (nVNS), during transient middle cerebral artery occlusion (MCAO), protects the blood-brain barrier (BBB), leading to reduced infarct size in ischemic brain. METHODS: Spontaneous hypertensive rats (SHRs) were subjected to a 90 min MCAO...
February 15, 2018: Brain Stimulation
Paul Boon, Elien De Cock, Ann Mertens, Eugen Trinka
PURPOSE OF REVIEW: Neurostimulation is becoming an increasingly accepted treatment alternative for patients with drug-resistant epilepsy (DRE) who are unsuitable surgery candidates. Standardized guidelines on when or how to use the various neurostimulation modalities are lacking. We conducted a systematic review on the currently available neurostimulation modalities primarily with regard to effectiveness and safety. RECENT FINDINGS: For vagus nerve stimulation (VNS), there is moderate-quality evidence for its effectiveness in adults with drug-resistant partial epilepsies...
April 2018: Current Opinion in Neurology
Priya Revathikumar, Johanna Estelius, Utsa Karmakar, Erwan Le Maître, Marina Korotkova, Per-Johan Jakobsson, Jon Lampa
The cholinergic anti-inflammatory pathway (CAP) is an innate neural reflex where parasympathetic and sympathetic nerves work jointly to control inflammation. Activation of CAP by vagus nerve stimulation (VNS) has paved way for novel therapeutic strategies in treating inflammatory diseases. Recently, we discovered that VNS mediated splenic acetylcholine (ACh) release and subsequent immunosuppression in response to LPS associated inflammation is impaired in mice lacking microsomal prostaglandin E synthase-1 (mPGES-1) expression, a key enzyme responsible for prostaglandin E2 synthesis...
2018: PloS One
Tugba Hirfanoglu, Ayse Serdaroglu, Ilker Cetin, Gokhan Kurt, Irem Y Capraz, Filiz Ekici, Ebru Arhan, Erhan Bilir
PURPOSE: The aim of this study was to evaluate the effects of vagus nerve stimulation (VNS) on heart rate variability (HRV) in children with epilepsy. METHODS: The subgroups of HRV, namely time domain (Standard deviation of NN interval (SDNN), SDNN index, Standard deviation of the averages of NN intervals (SDANN), Root mean square of successive differences (RMMSD), Adjacent NN intervals differing by more than 50 ms in the entire recording divided by the total number of all NN intervals (PNN50), triangular index) and frequency domain (Low-frequency (LF), High-frequency (HF), LF/HF), were investigated in 20 pediatric patients before and after 6 and 12months of VNS treatment during day and night by comparing their data with those of 20 control subjects...
February 17, 2018: Epilepsy & Behavior: E&B
P Palumbo, S Usai, C Amatucci, B Perotti, L Ruggeri, G Illuminati, G Tellan
BACKGROUND: The extension of indications for procedures in a Day Surgery (DS) setting has led to changes in the anesthetic and surgical treatment of Inguinal Hernias (IH). According to the recommendations of the European Hernia Society, the treatment of IH in DS units should be performed under Monitored Anesthesia Care (MAC). PATIENTS AND METHODS: 960 patients underwent IH repairs over a period of 24 months. The patients were randomly divided into two groups: R (remifentanil) and F (fentanyl); the group F was considered as a control group...
November 2017: Il Giornale di Chirurgia
Nicole A Pelot, Warren M Grill
Implanted vagus nerve stimulation (VNS) for obesity was recently approved by the FDA. However, its efficacy and mechanisms of action remain unclear. Herein, we synthesize clinical and preclinical effects of VNS on feeding behavior and energy balance and discuss engineering considerations for understanding and improving the therapy. Clinical cervical VNS (≤30 Hz) to treat epilepsy or depression has produced mixed effects on weight loss as a side effect, albeit in uncontrolled, retrospective studies. Conversely, preclinical studies (cervical and subdiaphragmatic VNS) mostly report decreased food intake and either decreased weight gain or weight loss...
February 6, 2018: Brain Research
François Trottier-Duclos, Véronique Desbeaumes Jodoin, Marie-Pierre Fournier-Gosselin, François Richer, Nathalie Desjardins, Sylvie Tieu, Paul Lespérance
OBJECTIVES: Treatment-resistant depression (TRD) carries a major burden on those affected by this disease and significantly impacts their quality of life (QOL). Vagus nerve stimulation (VNS) has showed promising results on symptoms, but its impact on QOL remains underresearched. This study aims to evaluate the long-term effects of VNS on both QOL and clinical symptoms for TRD patients, through a naturalistic 6-year follow-up. METHOD: Outpatients with confirmed TRD were enrolled to receive VNS...
February 7, 2018: Journal of ECT
Óscar Romero-Osorio, Sebastián Gil-Tamayo, Daniel Nariño, Diego Rosselli
PURPOSE: Perform a systematic review of the literature on the effects of vagus nerve stimulation (VNS), deep brain stimulation (DBS) and epilepsy surgery in subjective and objective sleep parameters. METHODS: We performed a literature search in the main medical databases: Medline, Embase, Cochrane, DARE and LILACS, looking for studies that evaluated the effects of VNS, DBS or epilepsy surgery on sleep parameters. In all, 36 studies, coming from 11 countries, including reviews, cohort studies, case series and case reports were included...
January 31, 2018: Seizure: the Journal of the British Epilepsy Association
Satyanarayana Gedela, Bilal Sitwat, William P Welch, Robert T Krafty, Yoshimi Sogawa
PURPOSE: This study explores the effect of Vagus Nerve Stimulator (VNS) on Status Epilepticus (SE) in children with medically intractable epilepsy. METHODS: Retrospective review was conducted in children with a history of at least two SE, who had VNS implantation and had at least one year follow up after the procedure. RESULTS: Sixteen patients met inclusion/exclusion criteria. The median age of seizure onset and surgery was 1.3 years and 9...
January 23, 2018: Seizure: the Journal of the British Epilepsy Association
James Winter, Michael Tipton, Michael J Shattock
This study tested the hypothesis that concomitant sympathetic and parasympathetic stimulation ("autonomic conflict") may act as a trigger for arrhythmia in long QT syndrome (LQTS). Studies were performed in isolated innervated rabbit hearts treated with clofilium (100 nmol/L); a potassium channel blocker. The influence of vagus nerve stimulation (VNS) on spontaneous ventricular arrhythmia was assessed in the absence/presence of sustained noradrenaline perfusion (100 nmol/L) and with sudden adrenergic stress (injections of noradrenaline into the perfusion line)...
February 2, 2018: Journal of Molecular and Cellular Cardiology
Ang Song Yee, John Tharakan, Zamzuri Idris, Shalini Bhaskar, Sanihah Abdul Halim, Salmi Abd Razak, Zabidi Azhar Mohd Hussin, Regunath Kandasamy, Wan Mohd Nazaruddin Wan Hassan, Laila Mukmin, Mohamad Hasyizan Hassan, Tan Yew Chin, Badrisyah Idris, Abdul Rahman Izaini Ghani, Hillol Kanti Pal, Jain George, Sani Sayuthi, Mohamed Saufi Awang, Jafri Malin Abdullah
Epilepsy surgery has been performed by a few centres in Malaysia, including Hospital Universiti Sains Malaysia (HUSM). To date, a total of 15 patients have undergone epilepsy surgery in HUSM. The epilepsy surgery included anterior temporal lobectomy (ATL) with amygdalohippocampectomy (AH) and Vagal nerve stimulation (VNS). The surgical outcomes of the patients were assessed using the International League Against Epilepsy (ILAE) outcome scale. The ILAE scores for patients who underwent ATL with AH were comparatively better than those who underwent VNS...
December 2017: Malaysian Journal of Medical Sciences: MJMS
Eric C Meyers, Bleyda R Solorzano, Justin James, Patrick D Ganzer, Elaine S Lai, Robert L Rennaker, Michael P Kilgard, Seth A Hays
BACKGROUND AND PURPOSE: Chronic impairment of the arm and hand is a common consequence of stroke. Animal and human studies indicate that brief bursts of vagus nerve stimulation (VNS) in conjunction with rehabilitative training improve recovery of motor function after stroke. In this study, we tested whether VNS could promote generalization, long-lasting recovery, and structural plasticity in motor networks. METHODS: Rats were trained on a fully automated, quantitative task that measures forelimb supination...
January 25, 2018: Stroke; a Journal of Cerebral Circulation
Bashar W Badran, Logan T Dowdle, Oliver J Mithoefer, Nicholas T LaBate, James Coatsworth, Joshua C Brown, William H DeVries, Christopher W Austelle, Lisa M McTeague, Mark S George
BACKGROUND: Electrical stimulation of the auricular branch of the vagus nerve (ABVN) via transcutaneous auricular vagus nerve stimulation (taVNS) may influence afferent vagal networks. There have been 5 prior taVNS/fMRI studies, with inconsistent findings due to variability in stimulation targets and parameters. OBJECTIVE: We developed a taVNS/fMRI system to enable concurrent electrical stimulation and fMRI acquisition to compare the effects of taVNS in relation to control stimulation...
December 29, 2017: Brain Stimulation
Krystal L Tomei, Christine Y Mau, Michael Ghali, Jayoung Pak, Ira M Goldstein
BACKGROUND: We describe three children with Angelman syndrome and medically refractory epilepsy. METHODS: Case series of three pediatric patients with Angelman syndrome and medically refractory epilepsy. All three patients failed medical treatment and were recommended for vagal nerve stimulator (VNS) implantation. RESULTS: Following VNS implantation, all three patients experienced reduction in seizure frequency greater than that afforded by medication alone...
January 19, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Aashish Jain, Dheeraj Arora, Yatin Mehta
The prevalence of epilepsy worldwide is around 0.5%-2% of the population. Antiepileptic medications are the first line of treatment in most of the cases but approximately 25%-30% epilepsy patients are refractory to the single or combination therapy. The surgical option for temporal lobe epilepsy is temporal lobectomy, which has its inherent risk of neurological deficits after the surgery. Patients who are either refractory to combination therapy or do not want surgical temporal lobectomy are the candidates for electrical stimulation therapy...
January 2018: Annals of Cardiac Anaesthesia
Philippe Ryvlin, Elson L So, Charles M Gordon, Dale C Hesdorffer, Michael R Sperling, Orrin Devinsky, Mark T Bunker, Bryan Olin, Daniel Friedman
OBJECTIVE: Limited data are available regarding the evolution over time of the rate of sudden unexpected death in epilepsy patients (SUDEP) in drug-resistant epilepsy. The objective is to analyze a database of 40 443 patients with epilepsy implanted with vagus nerve stimulation (VNS) therapy in the United States (from 1988 to 2012) and assess whether SUDEP rates decrease during the postimplantation follow-up period. METHODS: Patient vital status was ascertained using the Centers for Disease Control and Prevention's National Death Index (NDI)...
January 16, 2018: Epilepsia
Atilla Kircelli, Tufan Cansever, Cem Yılmaz
BACKGROUND: Epidural steroid injection is widely used to treat the short and long-term symptoms of low back and radicular pain. To the best of our knowledge, the influence of transforaminal epidural steroid injection (TFSI) combined with caudal epidural steroid injection (CESI) on pain intensity, patient satisfaction, and quality of life in lumbar radiculopathy has not been examined. AIM: To evaluate the short and long-term efficacy of TFSI, and TFSI combined with CESI (TFSI + CESI) in patients with lumbar radiculopathy...
January 2018: Neurology India
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