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Laryngeal motility alteration: A missing link between sleep apnea and vagus nerve stimulation for epilepsy
Author(s) -
Zambrelli Elena,
Saibene Alberto M.,
Furia Francesca,
Chiesa Valentina,
Vignoli Aglaia,
Pipolo Carlotta,
Felisati Giovanni,
Canevini Maria Paola
Publication year - 2016
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.13252
Subject(s) - vagus nerve stimulation , medicine , epilepsy , vagus nerve , anesthesia , obstructive sleep apnea , apnea , sleep apnea , larynx , stimulation , surgery , psychiatry
Summary This study aimed to evaluate the prevalence and the relationship of sleep breathing disorders ( SBD s) 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 SBD s. 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.