What is it about?
Vagus nerve stimulation is used for controlling epilepsy in patients where drug fail to achieve good seizure control. Such electrical stimulation is know to sometimes cause side effects also related to activation of larnygeal and pahryngeal muscles. This VNS patient progressively reported invalidating dysphagia (difficulty in swallowing), which was finally related to a macroscopic spasm in the pharyngeal and laryngeal musculature. Careful tuning of the stimulation parameters, performed by the epileptologist while the ENT surgeon conducted an endoscopic laryngeal evaluation allowed to solve the symptoms while keeping the stimulator active and allowing the patient to fully exploit its beneficial effects on seizure control
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Why is it important?
This is the first case report of a similar situation in the literature and it is interesting not only for diagnosing similar problems in patients undergoing vagus nerve stimulation for epilepsy but also because the collaboration between otolaryngologist and epileptologist allowed to control the symptoms without having to remove the stimulator or making it ineffective
Perspectives
A particularly challenging case, both for the patient and for his clinicians, which has been solved only through a well-trained collaboration, highlighting a pathological mechanism that wasn't known beforehand
Dr alberto maria saibene
Universita degli Studi di Milano
Read the Original
This page is a summary of: Pharyngolaryngeal spasm-induced dysphagia in an epileptic patient undergoing vagus nerve stimulation therapy, Clinical Case Reports, February 2020, Wiley,
DOI: 10.1002/ccr3.2761.
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