Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA.
Semin Pediatr Neurol. 2010 Mar;17(1):54-7. doi: 10.1016/j.spen.2010.02.009.
Vagus nerve stimulation has become an accepted adjunctive treatment for refractory epilepsy with more recent FDA approval in the treatment of depression. Many "positive" effects have been noted in patients with epilepsy namely increased alertness, improved cognition, behavior and mood. These changes appear to be independent of seizure reduction and antiepileptic drug decrease. We present two children (aged 8 and 9 years) who were non-verbal and spoke their first words shortly after vagus nerve stimulators were implanted. The mechanism is unclear although vagus nerve stimulation has been clearly shown to induce neuronal, chemical and perfusion changes in both subcortical and cortical regions of the brain. There is likely a combined effect on primary speech areas as well subcortical and mamillothalamic tracts, and possibly even stimulation and changes at the local vocal cord level contributing to this phenomenon. Our observation has important implications in encephalopathic patients both with and without epilepsy.
迷走神经刺激已成为难治性癫痫的一种公认的辅助治疗方法，最近 FDA 批准其用于治疗抑郁症。在癫痫患者中已经注意到许多“积极”的影响，即提高警觉性、改善认知、行为和情绪。这些变化似乎与减少癫痫发作和减少抗癫痫药物无关。我们介绍了两个孩子（年龄分别为 8 岁和 9 岁），他们在植入迷走神经刺激器后不久就开始说话。其机制尚不清楚，尽管迷走神经刺激已被明确证明可诱导大脑皮质和皮质下区域的神经元、化学和灌注变化。很可能对初级言语区以及皮质下和乳头丘脑束有联合作用，甚至可能在局部声带水平有刺激和变化，从而导致这种现象。我们的观察结果对患有和不患有癫痫的脑病患者都有重要意义。
