ASPIRATION - A POTENTIAL COMPLICATION TO VAGUS NERVE-STIMULATION

Purpose: Vagus nerve stimulation (VNS) is reported to reduce the frequ ency of seizures in children and adults without causing serious side e ffects. However, clinical observation of swallowing difficulties in 2 children treated with VNS made further investigation necessary. Method s: Seven patients aged 4-18 years and treated with VNS for 6-14 months were investigated with videoradiography during barium swallow. The ch ildren performed 5-30 barium swallow investigations with the VNS devic e turned off, running as programmed, or set at continuous stimulations . The degree of aspiration was scored from 0 to 3. Results: In 5 of 7 children, of whom reported transient swallowing difficulties, no chang e in the degree of aspiration was noted. The 2 children with swallowin g difficulties, however, showed increased aspiration score when the st imulator was set at continuous stimulations. In 1 the score also appea red to increase with the VNS running as programmed (p > 0.05). Both ch ildren had severe mental and motor disabilities. Conclusions: Before a nd during VNS treatment patients should be evaluated with regard to sw allowing problems. There needs to be an easy way to turn the device on and off to avoid aspirations, a hazardous and potentially life-threat ening complication of VNS.