Department of Neurology, The University of Colorado at Denver Health Science Center, Denver, Colorado, USA.
J Neurosurg. 2010 Apr;112(4):829-31. doi: 10.3171/2009.6.JNS09422.
Discontinuity in the silicone insulation over an electrode of a left vagus nerve stimulator (VNS) allowed the aberrant leak of current to the phrenic nerve and other structures. This resulted in ipsilateral diaphragmatic dysfunction, inability to vocalize, and severe radiating pain into the jaw and upper incisor for the duration of each stimulation. The device was explanted and a new device was implanted. All stimulation-related symptoms ceased immediately. A similar discontinuity in the silicone insulation is the likely explanation for several prior reports of poorly understood pains and phrenic nerve stimulation in patients with VNSs. The findings and analysis of this case establish a rationale for consideration of replacement of the VNS lead in all similarly symptomatic patients.
左迷走神经刺激器（VNS）电极的硅树脂绝缘层出现不连续，导致电流异常泄漏到膈神经和其他结构。这导致同侧膈肌功能障碍、无法发声，并在每次刺激期间出现严重的辐射性疼痛到下颌和上门牙。该设备被取出并植入了新设备。所有与刺激相关的症状立即停止。硅树脂绝缘层的类似不连续性可能是先前几例 VNS 患者不明原因疼痛和膈神经刺激报告的原因。该病例的发现和分析为所有类似症状患者考虑更换 VNS 导联提供了依据。
