Surgical complications of vagus nerve stimulation surgery: A 14-years single-center experience

van Schooten, Jouke; Smeets, Jacco; van Kuijk, Sander MJ.; Klinkenberg, Sylvia; Schijns, Olaf E.M.G.; Nelissen, Jeske; Wagner, Louis G.L.; Rouhl, Rob P.W.; Majoie, Marian H.J.M.; Rijkers, Kim

doi:10.1016/j.bas.2023.102733

Cited by 1 publication

(1 citation statement)

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“…Many studies have been done to investigate its safety and efficacy [ 3 ]. The reported complication rate from surgery or chronic stimulation ranges from 0-27.3% [ 8 , 10 , 11 ]. In our study, the rate of early complications from surgery is 24.8%.…”

Section: Discussionmentioning

confidence: 99%

Complications and Mortality Rate of Vagus Nerve Stimulation for Drug-Resistant Epilepsy

Ma,

Lehman,

Crutcher

et al. 2024

Cureus

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Objective: The goal of this study is to evaluate the complications and mortality associated with vagus nerve stimulation (VNS). Methods: We retrospectively reviewed medical records of patients who underwent VNS implantation for the treatment of drug-resistant epilepsy (DRE) between 2000 and 2023. The mean follow-up time was 10.6 years, ranging from three months to 22 years. Results: In total, 55 adult and pediatric patients received VNS therapy with 117 procedures performed over 23 years. The most common early complications were hoarseness and cough which were reported in eight adult patients (6.8%). Four children with intellectual disability (ID) had infection (3.4%), eight patients had lead breakage (6.8%), and two had device migration (1.7%). Four of all patients (7.3%) demonstrated late complications due to chronic nerve stimulation including vocal cord dysfunction, late-onset severe AV block, and obstructive sleep apnea (OSA). Three patients (5.5%) had VNS deactivated permanently due to complications and/or lack of efficacy. Two patients died from probable sudden unexpected death in epilepsy (SUDEP) with an incidence of 3.4/1000 person-years. Conclusions: VNS therapy is safe over long-term follow-up but not without risks. Most post-operative complications are minor and transient for adults. Children with ID tend to have infection and device migration. Late-onset cardiac complications and OSA can develop in some patients during VNS therapy and should not be overlooked. The SUDEP rate may decrease with VNS therapy over time.

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