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Journal of Pediatric Neurology 2021; 19(01): 031-035
DOI: 10.1055/s-0039-3402810
Case Report

Vagus Nerve Stimulator–Associated Sleep Disordered Breathing: Identification, Treatment, and Outcomes in a Pediatric Patient

Christopher M. Carosella
1   Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
,
David F. Smith
2   Division of Pediatric Otolaryngology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
3   Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
4   Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, United States
,
Kathleen M. Sarber
3   Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
,
Michele Turner
1   Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
,
Thomas J. Dye
1   Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
3   Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
4   Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, United States
› Author Affiliations Funding None.
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Abstract

Vagus nerve stimulator (VNS)-associated sleep disordered breathing (SDB) is a poorly understood side effect of VNS treatment. We present a patient with VNS-associated SDB who underwent sleep laboratory VNS titration, evaluation by drug-induced sleep endoscopy, and treatment including adenotonsillectomy and positive airway pressure therapy. This case is unique as it is the first to document, in real time, the inverse correlation of VNS current with airflow. This case offers unique insights into mechanisms and treatment of VNS-associated SDB, and a novel approach in its management. Most importantly, this case highlights the need for collaboration between physicians managing epilepsy with VNS and those managing sleep.

Keywords

vagus nerve stimulator - sleep disordered breathing - drug-induced sleep endoscopy


Publication History

Received: 07 November 2019

Accepted: 22 November 2019

Article published online:
20 January 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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