Bi-level VNS therapy with different therapy modes at night and daytime improves seizures and quality of life in a patient with drug-resistant epilepsy
Induction or aggravation of sleep apnea is a known side effect of vagus nerve stimulation (VNS). We report the case of a 44 year old male with drug-resistant epilepsy and depression who did not experience any seizure reduction after 1 year of VNS but a worsening of depression and daytime sleepiness....
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Epilepsy & Behavior Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589986423000515 |
| _version_ | 1797400881225793536 |
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| author | Berthold R. Voges |
| author_facet | Berthold R. Voges |
| author_sort | Berthold R. Voges |
| collection | DOAJ |
| description | Induction or aggravation of sleep apnea is a known side effect of vagus nerve stimulation (VNS). We report the case of a 44 year old male with drug-resistant epilepsy and depression who did not experience any seizure reduction after 1 year of VNS but a worsening of depression and daytime sleepiness. After confirming VNS-associated sleep apnea we started the first bi-level VNS therapy with standard VNS settings during daytime and reduced settings during nighttime. Anti-seizure medication remained unchanged. Within 12 months his seizure frequency was reduced by 90 % and his depression improved, permitting a cessation of his antidepressant medication. The observations made in this case have contributed to the manufacturer of VNS developing new generator models that can automatically provide bi-level VNS. |
| first_indexed | 2024-03-09T02:02:00Z |
| format | Article |
| id | doaj.art-a45c38bb11544be3878c158b1ba75d03 |
| institution | Directory Open Access Journal |
| issn | 2589-9864 |
| language | English |
| last_indexed | 2024-03-09T02:02:00Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Epilepsy & Behavior Reports |
| spelling | doaj.art-a45c38bb11544be3878c158b1ba75d032023-12-08T04:45:54ZengElsevierEpilepsy & Behavior Reports2589-98642023-01-0124100633Bi-level VNS therapy with different therapy modes at night and daytime improves seizures and quality of life in a patient with drug-resistant epilepsyBerthold R. Voges0Protestant Hospital Hamburg-Alsterdorf, Dpt. of Epileptology, Elisabeth-Flügge-Str.1, 22337 Hamburg, GermanyInduction or aggravation of sleep apnea is a known side effect of vagus nerve stimulation (VNS). We report the case of a 44 year old male with drug-resistant epilepsy and depression who did not experience any seizure reduction after 1 year of VNS but a worsening of depression and daytime sleepiness. After confirming VNS-associated sleep apnea we started the first bi-level VNS therapy with standard VNS settings during daytime and reduced settings during nighttime. Anti-seizure medication remained unchanged. Within 12 months his seizure frequency was reduced by 90 % and his depression improved, permitting a cessation of his antidepressant medication. The observations made in this case have contributed to the manufacturer of VNS developing new generator models that can automatically provide bi-level VNS.http://www.sciencedirect.com/science/article/pii/S2589986423000515Vns-therapySide effectsSleep-apneaSleep fragmentationNovel programming modeNocturnal output reduction |
| spellingShingle | Berthold R. Voges Bi-level VNS therapy with different therapy modes at night and daytime improves seizures and quality of life in a patient with drug-resistant epilepsy Epilepsy & Behavior Reports Vns-therapy Side effects Sleep-apnea Sleep fragmentation Novel programming mode Nocturnal output reduction |
| title | Bi-level VNS therapy with different therapy modes at night and daytime improves seizures and quality of life in a patient with drug-resistant epilepsy |
| title_full | Bi-level VNS therapy with different therapy modes at night and daytime improves seizures and quality of life in a patient with drug-resistant epilepsy |
| title_fullStr | Bi-level VNS therapy with different therapy modes at night and daytime improves seizures and quality of life in a patient with drug-resistant epilepsy |
| title_full_unstemmed | Bi-level VNS therapy with different therapy modes at night and daytime improves seizures and quality of life in a patient with drug-resistant epilepsy |
| title_short | Bi-level VNS therapy with different therapy modes at night and daytime improves seizures and quality of life in a patient with drug-resistant epilepsy |
| title_sort | bi level vns therapy with different therapy modes at night and daytime improves seizures and quality of life in a patient with drug resistant epilepsy |
| topic | Vns-therapy Side effects Sleep-apnea Sleep fragmentation Novel programming mode Nocturnal output reduction |
| url | http://www.sciencedirect.com/science/article/pii/S2589986423000515 |
| work_keys_str_mv | AT bertholdrvoges bilevelvnstherapywithdifferenttherapymodesatnightanddaytimeimprovesseizuresandqualityoflifeinapatientwithdrugresistantepilepsy |