Naslov
Vagus nerve stimulation is beneficial in a patient with postural orthostatic tachycardia syndrome: a case report

Autori
Bujan Kovač, Andreja ; Hajnšek, Sanja ; Petelin Gadže, Željka ; Nanković, Sibila ; Mrak, Goran ; Šulentić, Vlatko ; Kovačević, Ivana ; Adamec, Ivan ; Habek, Mario

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Clinical Neurophysiology, Volume 125, Supplement 1 / - , 2014, 699-699

Skup
30th International Congress of Clinical Neurophysiology (ICCN) of the IFCN

Mjesto i datum
Berlin, Njemačka, 19.-23.03.2014

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Postural tachycardia syndrome, Vagus nerve stimulation, Pharmacoresistance, Epilepsy

Sažetak
Question: Postural orthostatic tachycardia syndrome (POTS) is defined by a heart rate increment of 30 beats/min or more within 10 minutes of standing or head-up tilt (HUT) in the absence of orthostatic hypotension. Vagal nerve stimulation (VNS) is a safe and effective adjunctive treatment for drug-resistant epilepsy when surgery is inadvisable. Limited data suggest that long-term VNS therapy might affect cardiac autonomic function. However, there are no data of the VNS utility in patients with POTS. Methods: A 29-year-old female patient was implanted with VNS due to pharmacoresistant epilepsy (elementary sensory-motor partial seizures of the left extremities and complex partial seizures of temporal origin with occasional secondary generalization. Couple of years she noticed palpitations and dizziness in standing upright that were relieved by sitting or lying flat. Brain MRI showed bilateral frontoparietal polymicrogyria and right subependimal nodular heterotopia. During the preoperative work-up autonomic nervous system testing revealed POTS that was refractory to life style modification measures. Results: One weak after implantation, VNS was initiated at 0.25 mA (duty cycle set to a 30-Hz signal frequency, a 500-ms pulse width, 30 sec of on-time, and 3 min of off-time). HUT done at one month and three months after implantation was normal. VNS was gradually increased to 1 mA which led to significant reduction in seizure rate and disappearance of orthostatic intolerance symptoms. Conclusion: To our knowledge, this is the first reported case of the positive VNS effect in patient with POTS. Further studies with a larger number of patients are needed.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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