Vagus nerve stimulation therapy is effective and safe for startle-induced seizures

Miró, Júlia; Jaraba, Sònia; Mora, Jaume; Puig, Oriol Teixell; Castañer, Sara; Rodríguez-Bel, Laura; Santurino, Mila; Plans, Gerard; Falip, Mercé

doi:10.1016/j.jns.2015.04.048

Cited by 4 publications

(3 citation statements)

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“…However, this approach is limited by its high cost and invasiveness, potential need for reintervention for mechanical failure and/or battery re-placement, and side effects (Ventureyra, 2000 ). More recently, transcutaneous auricular VNS (taVNS) has been proposed to treat disorders such as epilepsy (Miro et al, 2015 ) and depression, drawing inspiration from auricular acupuncture of traditional chinese medicine (Rong et al, 2016 ). The rationale for using taVNS is that anatomical studies showed that the ear is the only place on the surface of the human body where afferent vagal nerve distribution is present (Wang et al, 2014 ).…”

Section: The Ans As a Therapeutic Target In Obesitymentioning

confidence: 99%

The Role of the Autonomic Nervous System in the Pathophysiology of Obesity

et al. 2017

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Obesity is reaching epidemic proportions globally and represents a major cause of comorbidities, mostly related to cardiovascular disease. The autonomic nervous system (ANS) dysfunction has a two-way relationship with obesity. Indeed, alterations of the ANS might be involved in the pathogenesis of obesity, acting on different pathways. On the other hand, the excess weight induces ANS dysfunction, which may be involved in the haemodynamic and metabolic alterations that increase the cardiovascular risk of obese individuals, i.e., hypertension, insulin resistance and dyslipidemia. This article will review current evidence about the role of the ANS in short-term and long-term regulation of energy homeostasis. Furthermore, an increased sympathetic activity has been demonstrated in obese patients, particularly in the muscle vasculature and in the kidneys, possibily contributing to increased cardiovascular risk. Selective leptin resistance, obstructive sleep apnea syndrome, hyperinsulinemia and low ghrelin levels are possible mechanisms underlying sympathetic activation in obesity. Weight loss is able to reverse metabolic and autonomic alterations associated with obesity. Given the crucial role of autonomic dysfunction in the pathophysiology of obesity and its cardiovascular complications, vagal nerve modulation and sympathetic inhibition may serve as therapeutic targets in this condition.

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Section: The Ans As a Therapeutic Target In Obesitymentioning

confidence: 99%

The Role of the Autonomic Nervous System in the Pathophysiology of Obesity

et al. 2017

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“…Commonly used treatments with relative efficiency include Lamotrigine [25,26], Oxcarbazepine, and benzodiazepines [8]. Vagus nerve stimulation was effective in isolated case reports [27]. Non-invasive sound generator treatment [28] could reduce 50% of seizure-frequency in two patients out of four.…”

Section: Treatmentmentioning

confidence: 99%

Clinical and electrophysiological pattern of startle epilepsy: a comprehensive literature review

Cheval

Jonas

2022

Emerg Neurol

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Startle epilepsy is a rare form of epilepsy characterized by recurrent seizures that are triggered by a surprising stimulus. It affects children between 10 months and 14 years of age, with a history of brain damage due to ante- or neonatal hypoxia, and hemiparesis. The most common triggers for these seizures are auditory stimulation, followed by somesthetic stimulation and visual stimulation. Typical startle seizures are rare, and they have a large variety of clinical manifestations. The most frequent type is short hemitonic flexion seizures, followed by myoclonic seizures, and bilateral tonic seizures. Few studies have focused on the electrophysiological features of this condition and the literature is controversial regarding the EEG pattern. Interictal EEG is often normal. The most frequent interictal abnormalities are a slowing of the background rhythm, associated with focal spikes in the frontal, central, and parietal regions. Several ictal EEG patterns have been reported: diffuse flattening of the background rhythm, focal fast activity, an isolated focal spike followed by a discharge of spikes. Intracerebral EEG recording shows primary and secondary motor cortex involvement as initial discharge areas. The most efficient antiepileptic drugs are Lamotrigine, Oxcarbazepine, and benzodiazepines. But most patients are often drug-resistant. Surgery is a possible albeit rare therapeutic option. We describe the case of a 13-year-old female patient with hemitonic seizures triggered by surprising auditory stimuli. The video EEG allowed us to record and define an EEG pattern of her seizures. Interictal EEG showed right fronto-central abundant spikes. The ictal EEG showed right fronto-central and medial spikes followed by a fronto-central fast rhythm discharge. The clinical and electrographic data permitted the diagnosis of startle epilepsy. Our patient was treated with Levetiracetam during 6 months followed by Oxcarbazepine and Clobazam with a partial improvement (reduction of the frequency of focal to bilateral tonic-clonic seizures). Considering the usual pharmaco-resistance of this type of epilepsy, we proposed our patient a presurgical evaluation. This case shows that the diagnosis should be considered in paroxysmal dystonic movements with a stereotyped triggering factor, and underlines the importance of repeating the EEG recordings in this type of epilepsy. In this article we will review the literature, discuss the underlying pathophysiology, and identify the common electrophysiological characteristics associated with startle epilepsy.

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“…Vagus nerve stimulation treatment may also have therapeutic effects on epilepsy of some individual etiology or epilepsy syndrome, such as the tuberous sclerosis complex (TSC), Lennox‐Gastaut syndrome (LGS), generalized epilepsy with febrile seizures plus (GEFS+), absence epilepsy, status epilepticus (SE), reflex eating seizures, and startle‐induced seizures . Grioni and Landi followed up 4 DRE patients with tuberous sclerosis complex (TSC) treated with VNS.…”

Section: Applicationmentioning

confidence: 99%

Research progress of vagus nerve stimulation in the treatment of epilepsy

Fan

Shan

et al. 2019

CNS Neurosci Ther

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The International League Against Epilepsy (ILAE) defined drug‐resistant epilepsy (DRE) that epilepsy seizure symptoms cannot be controlled with two well‐tolerated and appropriately chosen antiepileptic drugs, whether they are given as monotherapy or in combination. According to the WHO reports, there is about 30%‐40% of epilepsy patients belong to DRE. These patients need some treatments other than drugs, such as epilepsy surgery, and neuromodulation treatment. Traditional surgical approaches may be limited by the patient's clinical status, pathological tissue location, or overall prognosis. Thus, neuromodulation is an alternative choice to control their symptoms. Vagus nerve stimulation (VNS) is one of the neuromodulation methods clinically, which have been approved by the Food and Drug Administration (FDA). In this review, we systematically describe the clinical application, clinical effects, possible antiepileptic mechanisms, and future research directions of VNS for epilepsy.

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Vagus nerve stimulation therapy is effective and safe for startle-induced seizures

Cited by 4 publications

References 10 publications

The Role of the Autonomic Nervous System in the Pathophysiology of Obesity

The Role of the Autonomic Nervous System in the Pathophysiology of Obesity

Clinical and electrophysiological pattern of startle epilepsy: a comprehensive literature review

Research progress of vagus nerve stimulation in the treatment of epilepsy

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