Related Experiment Video
Updated: Jul 13, 2026
Implantation Surgery for Abdominal Vagus Nerve Stimulation and Recording Studies in Awake Rats
Published on: January 19, 2024
Vagus nerve stimulation in children with refractory epilepsy: unusual complications and relationship to
Divya S Khurana1, Marko Reumann, Elizabeth F Hobdell
1Section of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA 19134, USA. Divya.Khurana@drexelmed.edu
Insights
Vagus nerve stimulation (VNS) effectively treats refractory epilepsy in children, with over half experiencing significant seizure reduction. Careful consideration of obstructive sleep apnea before VNS implantation is recommended.
Area of Science:
- Pediatric Neurology
- Epilepsy Treatment
- Neurostimulation
Background:
- Vagus nerve stimulation (VNS) is an approved epilepsy treatment for patients over 12.
- Limited data exists on VNS adverse events in young children.
Purpose of the Study:
- To evaluate the safety and efficacy of VNS in young children with refractory epilepsy.
- To identify potential adverse events associated with VNS in this pediatric population.
Main Methods:
- Retrospective chart review of 26 children (ages 3-17) who underwent VNS implantation for refractory epilepsy between 1998 and 2004.
- Analysis of seizure frequency, adverse events, and treatment outcomes.
Main Results:
- 54% of patients achieved >50% seizure reduction, with 2 achieving seizure freedom.
- 15% of patients developed obstructive sleep apnea (OSA) post-VNS.
- Unusual complications included intractable cough and infection requiring device removal.
Conclusions:
- VNS demonstrates efficacy in treating refractory epilepsy in children.
- Pre-implantation polysomnography is advised to screen for OSA.
- Rare complications like persistent cough and infection necessitate careful monitoring.
Background:
Vagus nerve stimulation (VNS) is approved for use in patients with refractory epilepsy over the age of 12 years. While this procedure is widely used, there is little data on adverse events in young children.
Materials And Methods:
A retrospective chart review was conducted on 26 children who had VNS implantation for refractory epilepsy from 1998 to 2004.
Results:
Ages ranged from 3 to 17 years (16 boys and 10 girls). Seventy-seven percent had moderate to severe mental retardation. Sixty-five percent had more than 30 seizures per month. Symptomatic-generalized epilepsy was the predominant epilepsy syndrome seen in 77% of children. The duration of VNS treatment ranged from 1 month to 8 years (mean = 3.5 years). Twenty of 26 patients (77%) were on rapid-cycling mode. More than 50% reduction in seizure frequency was noted in 54% with two patients achieving seizure freedom. Twenty-three percent had less than 50% seizure reduction. Four patients were able to terminate seizures with use of the magnet. VNS was removed from one patient because of intractable cough persisting in spite of stimulation being turned off for 1 month. Another patient had it removed twice for infection. Obstructive sleep apnea (OSA) was observed in four patients (15%) after placement of VNS.
Conclusion:
VNS appears to be an effective treatment for children with refractory epilepsy. Development of intractable cough in one patient in spite of device being turned off and recurrent infection-related removal in another are unusual complications. Polysomnography before implantation of VNS should be considered to identify patients with pre-existing OSA.
Related Concept Videos
01:27Restless Leg Syndrome and Night Terrors
The exact cause of RLS is not fully understood, but it is believed to involve dopamine, a neurotransmitter that helps regulate muscle movement. Imbalances in dopamine levels...
01:15REM Sleep Behavior Disorder
RBD is significantly associated with...
01:21Sleep Apnea
The condition is more prevalent among...
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...