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- Title
Laryngeal motility alteration: A missing link between sleep apnea and vagus nerve stimulation for epilepsy.
- Authors
Zambrelli, Elena; Saibene, Alberto M.; Furia, Francesca; Chiesa, Valentina; Vignoli, Aglaia; Pipolo, Carlotta; Felisati, Giovanni; Canevini, Maria Paola
- Abstract
This study aimed to evaluate the prevalence and the relationship of sleep breathing disorders ( SBDs) and laryngeal motility alterations in patients with drug-resistant epilepsy after vagus nerve stimulator ( VNS) implantation. Twenty-three consecutive patients with medically refractory epilepsy underwent out-of-center sleep testing before and after VNS implantation. Eighteen eligible subjects underwent endoscopic laryngeal examination post- VNS implantation. Statistical analysis was carried out to assess an association between laryngeal motility alterations and the onset/worsening of SBDs. After VNS implantation, 11 patients showed a new-onset mild/moderate SBD. Half of the patients already affected by obstructive sleep apnea (OSA) showed worsening of SBD. All of the patients with a new-onset OSA had a laryngeal pattern with left vocal cord adduction ( LVCA) during VNS stimulation. The association between VNS-induced LVCA and SBD was statistically significant. This study suggests an association between VNS and SBD, hinting to a pivotal role of laryngeal motility alterations. The relationship between SBD and VNS-induced LVCA supports the need to routinely investigate sleep respiratory and laryngeal motility patterns before and after VNS implantation.
- Subjects
TREATMENT of epilepsy; SLEEP apnea syndromes; LARYNGEAL nerves; VAGUS nerve; NEURAL stimulation
- Publication
Epilepsia (Series 4), 2016, Vol 57, Issue 1, pe24
- ISSN
0013-9580
- Publication type
Article
- DOI
10.1111/epi.13252