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An electrical cause of stridor: pediatric vagal nerve stimulators

Gregory Kelts1, Peter D O'Connor2, Richard W Hussey3

  • 1San Antonio Uniformed Services Health Education Consortium, Otolaryngology, United States.

International Journal of Pediatric Otorhinolaryngology
|December 16, 2014
PubMed

Insights

Vagal nerve stimulators (VNS) can cause breathing issues like stridor and sleep apnea in children with epilepsy. Adjusting VNS device settings resolved these adverse effects, improving patient outcomes.

Area of Science:

  • Pediatric Otolaryngology
  • Neurology
  • Medical Device Engineering

Background:

  • Vagal nerve stimulators (VNS) are FDA-approved implantable devices for treating refractory epilepsy in children.
  • Potential side effects of VNS implantation require careful monitoring and management.

Observation:

  • Two pediatric patients with epilepsy developed stridor and sleep apnea post-VNS implantation.
  • Clinical evaluation included flexible laryngoscopy, direct laryngoscopy, and bronchoscopy.

Findings:

  • Vocal fold and supraglottis contraction was observed in both patients.
  • Adjusting VNS device parameters successfully eliminated these contractions.

Implications:

  • VNS device settings may need optimization to prevent or treat airway complications.
  • This highlights the importance of multidisciplinary care in managing VNS therapy side effects.

Keywords:
Direct laryngoscopySleep apneaStridorVagal nerve stimulator

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