Naslov
Bronchoconstriction induced by vagus nerve stimulation in a patient with pharmacoresistant epilepsy and bronchial asthma: a case report

Autori
Hajnšek, Sanja ; Samaržija, Miroslav ; Šulentić, Vlatko ; Mijatović, Dragana ; Petelin Gadže, Željka ; Nanković, Sibila ; Radić, Boris

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

Skup
V. hrvatski neurološki kongres s međunarodnim sudjelovanjem

Mjesto i datum
Vukovar, Hrvatska, 30.09.2009. - 04.10.2009

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
vagus nerve stimulation; epilepsy; asthma

Sažetak
One percent of the general population is affected with epilepsy and close to thirty percent of epilepsy patients are intractable to medications in spite of a recent increase in the number of new available antiepileptic drugs. Resection epilepsy surgery is an alternative, but not every patient with pharmacoresistant epilepsy is a good candidate for this type of surgery. Vagus-nerve stimulation (VNS) is a relatively new device that is finding increased use in the non-pharmacologic management of refractory epilepsy. Vagus nerve stimulators are implanted in the subcutaneus tissues of the chest, with a wire lead inserted around the left vagus nerve to deliver regularly timed cycles of electrical pulses that suppress epileptogenic foci. Adverse events related to VNS include voice alteration and a tingling sensation in the throat, but the intensity of the symptoms decreases over the next few weeks. Coughing during stimulation occurrs normally when therapy is initiated and shortness of breath occurrs mainly during physical activity, but dyspnea and bronchoconstriction are very rare. We report a case of a 37-year old woman with a 27-year history of pharmacoresistant simple partial sensomotor seizures, cortical dysgenesis of precentral gyrus (Taylor) and a 19-year history of bronchial asthma. In March 2009, one year after VNS implantation, she experienced dyspnea associated with the activation of device, and was found to temporally correlate with worsening of asthma - bronchoconstriction as demonstrated by pulmonary function assessments. Following therapy with antibiotics, bronchodilatators and corticosteroids her condition improved. In patients with bronchial asthma and implanted VNS by experience there is a difficulty in achievement of regression of asthma symptoms, probably because of the continuous activation of the parasympathetic nervous system.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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