Department of Neurosurgery, Medical University of Luebeck, Luebeck, Germany.
Neurosurgery. 2010 Dec;67(2 Suppl Operative):489-94. doi: 10.1227/NEU.0b013e3181f88867.
The treatment of refractory epilepsy by vagus nerve stimulation (VNS) is a well-established therapy option for patients not suitable for epilepsy surgery and therapy refractory depressions.
To analyze surgical and technical complications after implantation of left-sided VNS in patients with therapy-refractory epilepsy and depression.
One hundred five patients receiving a VNS or VNS-related operations (n = 118) from 1999 to 2008 were investigated retrospectively.
At the time of operation, 84 patients were younger than 18 years, with a mean age of 10.5 years. Twenty (19%) patients had technical problems or complications. In 6 (5.7%) patients these problems were caused by the operation. The device was removed in 8 cases. The range of surgically and technically induced complications included electrode fractures, early and late onset of deep wound infections, transient vocal cord palsy, cardiac arrhythmia under test stimulation, electrode malfunction, and posttraumatic dysfunction of the stimulator.
VNS therapy is combined with a wide spread of possible complications. Technical problems are to be expected, including electrode fracture, dislocation, and generator malfunction. The major complication in younger patients is the electrode fracture, which might be induced by growth during adolescence. Surgically induced complications of VNS implantation are comparably low. Cardiac symptoms and recurrent nerve palsy need to be taken into consideration.
迷走神经刺激（VNS）治疗难治性癫痫是一种成熟的治疗方法，适用于不适合癫痫手术和治疗难治性抑郁症的患者。
分析左侧 VNS 植入术后治疗难治性癫痫和抑郁症患者的手术和技术并发症。
回顾性调查了 1999 年至 2008 年间接受 VNS 或与 VNS 相关手术（n = 118）的 105 例患者。
手术时，84 例患者年龄小于 18 岁，平均年龄为 10.5 岁。20 例（19%）患者存在技术问题或并发症。其中 6 例（5.7%）由手术引起。8 例患者取出了设备。手术和技术引起的并发症范围包括电极断裂、深部伤口感染的早期和晚期发作、短暂声带麻痹、测试刺激下的心律失常、电极功能障碍以及刺激器的创伤后功能障碍。
VNS 治疗与广泛的潜在并发症有关。预计会出现技术问题，包括电极断裂、脱位和发生器故障。在年轻患者中，主要并发症是电极断裂，这可能是由于青春期生长引起的。VNS 植入的手术并发症相对较低。需要考虑心脏症状和复发性神经麻痹。
