Vagus nerve stimulation for epilepsy activates the vocal folds maximally at therapeutic levels

Epilepsy Research
J J ArdeschH P J Buschman

Abstract

Vagus nerve stimulation (VNS) for medically refractory epilepsy can give hoarseness due to stimulation of the recurrent laryngeal nerve. For a group of VNS-therapy users this side-effect interferes severely with their daily activities. Our goal was to investigate the severity of intra-operative VNS-related vocal fold contraction at different pulse widths and current output parameters. We investigated electromyographic and morphometric alterations on the vocal folds during VNS. Vocal fold EMG experiments were conducted intra-operatively during the implantation of a VNS system. During surgery the VNS pulse generator was programmed to stimulate at different pulse durations. At each pulse width the EMG-threshold current was determined by electrical stimulation of the vagus nerve with increasing stimulation currents. Laryngostroboscopic examination was performed after surgery to analyze the effects of spontaneous stimulation on the larynx. The vocal fold EMG and morphodynamic changes in the larynx have been analyzed in eight patients. In all patients left vocal fold EMG-threshold was between 0.25 and 0.50 mA. Pulse duration had little influence on the EMG-threshold level. Vocal fold EMG saturation levels were reached between 0.75 an...Continue Reading

References

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Citations

Sep 6, 2012·Neuromodulation : Journal of the International Neuromodulation Society·Chengyuan Wu, Ashwini D Sharan
Sep 28, 2013·Journal of Voice : Official Journal of the Voice Foundation·Amanda I GillespieClark A Rosen
Mar 15, 2011·Journal of the Neurological Sciences·Yvan TranSandeep Mittal
Mar 22, 2015·Journal of Voice : Official Journal of the Voice Foundation·Kristiane Van LierdeKristl Vonck
Nov 3, 2015·Seizure : the Journal of the British Epilepsy Association·Daphne M MuldersMichel J A M van Putten
Oct 30, 2015·International Journal of Neural Systems·Annelies GrimonprezKristl Vonck
Apr 7, 2016·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Sandi LamPeter C Warnke
Sep 21, 2010·Experimental Neurology·Mark A CastoroWarren M Grill
Dec 17, 2014·International Journal of Pediatric Otorhinolaryngology·Gregory KeltsStephen Maturo
Oct 16, 2016·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Alberto M SaibeneEnrico Alfonsi
Apr 28, 2020·Laryngoscope Investigative Otolaryngology·Helen L KochilasW Brent Tarver
Nov 25, 2020·Pediatric Clinics of North America·Manju Hurvitz, Miles Weinberger
Sep 3, 2021·Journal of Veterinary Internal Medicine·Thomas R Harcourt-Brown, Michael Carter

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