Pharyngolaryngeal spasm‐induced dysphagia in an epileptic patient undergoing vagus nerve stimulation therapy

Castellani, Luca; Chiesa, Valentina; Maccari, Alberto; Fuccillo, Emanuela; Canevini, Maria Paola; Felisati, Giovanni; Saibene, Alberto Maria

doi:10.1002/ccr3.2761

Cited by 1 publication

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References 14 publications

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“…Symptoms of laryngopharyngeal dysfunction are commonly associated with VNS therapy, occurring in approximately two-thirds of patients [20]. Patients describe transient episodes of dysphonia, shortness of breath and coughing only during stimulation periods, indicative of recurrent laryngeal nerve stimulation and left vocal cord adduction [21][22][23]. Left vocal cord paresis has also been described due to vagus nerve damage during lead implantation.…”

Section: Airway Obstruction and Pulmonary Aspirationmentioning

confidence: 99%

Management of vagus nerve stimulation therapy in the peri‐operative period

et al. 2023

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Summary Vagus nerve stimulation is a well‐established treatment option for patients with drug‐resistant epilepsy and has an expanding range of other clinical indications. Side effects of vagus nerve stimulation therapy include: cough; voice changes; vocal cord adduction; rarely, obstructive sleep apnoea; and arrhythmia. Patients with implanted vagus nerve stimulation devices may present for unrelated surgery and critical care to clinicians who are unfamiliar with their function and safe management. These guidelines have been formulated by multidisciplinary consensus based on case reports, case series and expert opinion to support clinicians in the management of patients with these devices. The aim is to provide specific guidance on the management of vagus nerve stimulation devices in the following scenarios: the peri‐operative period; peripartum period; during critical illness; and in the MRI suite. Patients should be aware of the importance of carrying their personal vagus nerve stimulation device magnet with them at all times to facilitate urgent device deactivation if necessary. We advise that it is generally safer to formally deactivate vagus nerve stimulation devices before general and spinal anaesthesia. During periods of critical illness associated with haemodynamic instability, we also advise cessation of vagus nerve stimulation and early consultation with neurology services.

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