Vagus nerve stimulation as a potential modulator of periictal psychotic episodes: A report of four cases
Drug resistant epilepsy (DRE) has been associated with a high incidence of psychotic disorders. Patients can develop psychosis after starting a new antiseizure medication, after undergoing resective surgery, or after implantation of a vagus nerve stimulation (VNS) system. The aim of this study was t...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-01-01
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| Series: | Epilepsy & Behavior Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589986421000083 |
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| author | Montse Alemany Eva Real Núria Custal Jacint Sala-Padró Laura Rodríguez-Bel Gerard Plans Jaume Mora Mila Santurino Tim Vancamp Mercè Falip |
| author_facet | Montse Alemany Eva Real Núria Custal Jacint Sala-Padró Laura Rodríguez-Bel Gerard Plans Jaume Mora Mila Santurino Tim Vancamp Mercè Falip |
| author_sort | Montse Alemany |
| collection | DOAJ |
| description | Drug resistant epilepsy (DRE) has been associated with a high incidence of psychotic disorders. Patients can develop psychosis after starting a new antiseizure medication, after undergoing resective surgery, or after implantation of a vagus nerve stimulation (VNS) system. The aim of this study was to investigate the modulation effect of VNS on psychotic episodes in DRE patients with a pre-existing history of periictal psychotic episodes (PPE).We retrospectively report the outcome of four patients from a single tertiary center with PPE prior to implantation. None of the implanted patients developed de novo PPE after VNS therapy. Regarding seizure outcome, all patients demonstrated a response to VNS with two who experienced who status epilepticus and three patients wtih a change in semiology with after VNS implantation. PPE disappeared in all the study patients, two of them at 6 months post-implantation and in the others after 2 and 3 years, respectively. 18F-FDG-PET results showed hypermetabolism in both anterior insular and medial frontal lobes which disappeared in the 18F -FDG-PET 4 years post-implantation.Based on the results of this series of cases we suggest that VNS therapy may be useful to modulatet PPE in patients with DRE, though effectiveness may be time-dependent. |
| first_indexed | 2024-12-20T00:13:37Z |
| format | Article |
| id | doaj.art-9ce0f7a95c184e31afd4e2f5b81db841 |
| institution | Directory Open Access Journal |
| issn | 2589-9864 |
| language | English |
| last_indexed | 2024-12-20T00:13:37Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Epilepsy & Behavior Reports |
| spelling | doaj.art-9ce0f7a95c184e31afd4e2f5b81db8412022-12-21T20:00:25ZengElsevierEpilepsy & Behavior Reports2589-98642021-01-0115100434Vagus nerve stimulation as a potential modulator of periictal psychotic episodes: A report of four casesMontse Alemany0Eva Real1Núria Custal2Jacint Sala-Padró3Laura Rodríguez-Bel4Gerard Plans5Jaume Mora6Mila Santurino7Tim Vancamp8Mercè Falip9Neuro-Oncology Unit, Neurology Department, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, SpainEpilepsy Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, SpainEpilepsy Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, SpainEpilepsy Unit, Neurology Department, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, SpainInstitute of Image Diagnosis (IDI), PET Division, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, SpainEpilepsy Unit, Neurosurgery Department, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, SpainInstitute of Image Diagnosis (IDI), SPECT division, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, SpainEpilepsy Unit, Neurology Department, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spaine4Sci, Sabadell, SpainEpilepsy Unit, Neurology Department, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain; Corresponding author at: Epilepsy Unit, Neurology Department, Hospital Universitari de Bellvitge, Feixa Llarga S/N, 08907 Hospitalet de Llobregat, Barcelona, Spain.Drug resistant epilepsy (DRE) has been associated with a high incidence of psychotic disorders. Patients can develop psychosis after starting a new antiseizure medication, after undergoing resective surgery, or after implantation of a vagus nerve stimulation (VNS) system. The aim of this study was to investigate the modulation effect of VNS on psychotic episodes in DRE patients with a pre-existing history of periictal psychotic episodes (PPE).We retrospectively report the outcome of four patients from a single tertiary center with PPE prior to implantation. None of the implanted patients developed de novo PPE after VNS therapy. Regarding seizure outcome, all patients demonstrated a response to VNS with two who experienced who status epilepticus and three patients wtih a change in semiology with after VNS implantation. PPE disappeared in all the study patients, two of them at 6 months post-implantation and in the others after 2 and 3 years, respectively. 18F-FDG-PET results showed hypermetabolism in both anterior insular and medial frontal lobes which disappeared in the 18F -FDG-PET 4 years post-implantation.Based on the results of this series of cases we suggest that VNS therapy may be useful to modulatet PPE in patients with DRE, though effectiveness may be time-dependent.http://www.sciencedirect.com/science/article/pii/S2589986421000083Vagus nerve stimulationPeriictal psychotic episodesDrug-resistant epilepsyPsychosisPositron emission tomography |
| spellingShingle | Montse Alemany Eva Real Núria Custal Jacint Sala-Padró Laura Rodríguez-Bel Gerard Plans Jaume Mora Mila Santurino Tim Vancamp Mercè Falip Vagus nerve stimulation as a potential modulator of periictal psychotic episodes: A report of four cases Epilepsy & Behavior Reports Vagus nerve stimulation Periictal psychotic episodes Drug-resistant epilepsy Psychosis Positron emission tomography |
| title | Vagus nerve stimulation as a potential modulator of periictal psychotic episodes: A report of four cases |
| title_full | Vagus nerve stimulation as a potential modulator of periictal psychotic episodes: A report of four cases |
| title_fullStr | Vagus nerve stimulation as a potential modulator of periictal psychotic episodes: A report of four cases |
| title_full_unstemmed | Vagus nerve stimulation as a potential modulator of periictal psychotic episodes: A report of four cases |
| title_short | Vagus nerve stimulation as a potential modulator of periictal psychotic episodes: A report of four cases |
| title_sort | vagus nerve stimulation as a potential modulator of periictal psychotic episodes a report of four cases |
| topic | Vagus nerve stimulation Periictal psychotic episodes Drug-resistant epilepsy Psychosis Positron emission tomography |
| url | http://www.sciencedirect.com/science/article/pii/S2589986421000083 |
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