Journal of Pediatric Neurology
DOI: 10.1055/s-0039-3402810
Case Report
Georg Thieme Verlag KG Stuttgart · New York

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.
Further Information

Publication History

07 November 2019

22 November 2019

Publication Date:
20 January 2020 (online)

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.