Impact of vagus nerve stimulation on sleep-related breathing disorders in adults with epilepsy.

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Version: Author's accepted manuscript
Serval ID
serval:BIB_A91CA09B347D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of vagus nerve stimulation on sleep-related breathing disorders in adults with epilepsy.
Journal
Epilepsy & behavior
Author(s)
Salvadé A., Ryvlin P., Rossetti A.O.
ISSN
1525-5069 (Electronic)
ISSN-L
1525-5050
Publication state
Published
Issued date
02/2018
Peer-reviewed
Oui
Volume
79
Pages
126-129
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Vagus nerve stimulation (VNS) can induce a sleep apnea syndrome (SAS), which in turn can worsen seizure control and represents a cardiovascular risk factor. Epidemiology of VNS-induced SAS has received little attention to date. The purpose of this study was to estimate the VNS-induced SAS prevalence and to explore clinical variables potentially correlating with its development.
We analyzed the computerized medical records of 18 consecutive adults treated for refractory epilepsy with VNS, implanted between May 2008 and October 2015. Patients underwent sleep polygraphy or polysomnography before and after VNS implantation. Between patients with and without SAS, we compared variables related to epilepsy type and device parameters.
Two patients had SAS and were treated before implantation; one improved after VNS, the other worsened. Four other patients developed SAS after VNS: induced/aggravated SAS occurred in 5/18 patients (prevalence: 27.8%). Only 2 of them had symptoms: one complained of important snoring, the other reported seizure worsening. All 5 patients were successfully treated by combinations of continuous positive airway pressure (cPAP), positional therapy, or VNS parameters modification. There was no statistically significant difference between potential predictors.
Despite the relatively modest clinical impact on epilepsy, in view of the associated cardiovascular risk factor development, easy treatment, and the relatively high SAS prevalence, routine screening for SAS before and after VNS implantation may represent a reasonable practice.
Keywords
Adolescent, Adult, Continuous Positive Airway Pressure, Epilepsy/complications, Epilepsy/physiopathology, Epilepsy/therapy, Female, Humans, Male, Middle Aged, Polysomnography, Retrospective Studies, Seizures/etiology, Sleep, Sleep Apnea Syndromes/epidemiology, Treatment Outcome, Vagus Nerve/physiology, Vagus Nerve/physiopathology, Vagus Nerve Stimulation/adverse effects, Predictive factors, Prevalence, SAS, VNS
Pubmed
Web of science
Open Access
Yes
Create date
04/01/2018 17:09
Last modification date
20/08/2019 16:13
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