Analysis of postoperative complications of vagus nerve stimulation for pediatric refractory epilepsy
Chen Shuai, Xie Zihang, Deng Jie, Zheng Lili, Chen Chunhong, Wang Xiaofei, Ding Changhong, Chen Feng, Fang Fang, Fang Tie
Abstract
ObjectiveTo analyze the postoperative complications of vagus nerve stimulation (VNS) in children with refractory epilepsy, and to explore the corresponding treatment strategies.
MethodsA retrospective study was conducted on the clinical data of 294 children with refractory epilepsy who were treated with VNS at Department of Functional Neurosurgery, Beijing Children′s Hospital, Capital Medical University from September 2015 to December 2019 and followed up for more than 6 months. Postoperative complications were documented. Corresponding treatment and outcomes were summarized.
ResultsAmong 294 patients, 23 cases (7.8%) had postoperative complications related to operation or hardware, including throat-related complications (4.4%, 13/294) which was mostly commonly observed, superficial incision infection(2.0%, 6/294), deep incision infection (1.4%, 4/294), subcutaneous hematoma around VNS device(0.7%, 2/294) and immune rejection (0.3%, 1/294). The local symptoms disappeared after anti-infection treatment in 6 children with superficial incision infection after operation. Among 4 children with deep incision infection, the infection was effectively controlled after removal of the VNS device and anti-infection treatment. In 2 children with subcutaneous hematoma around the stimulation device, the hematoma was resolved following pressure dressing and dressing change. In 1 child with immune rejection, the symptoms disappeared after all VNS devices were removed. In 13 children with throat complications, the symptoms disappeared after the programming of VNS and postoperative rehabilitation.
ConclusionsThe incidence of postoperative complications of VNS in children with refractory epilepsy is low, and throat complications and infections are the most common. The outcomes of various complications are satisfactory after corresponding treatment. Many technical aspects in surgical operations are associated with postoperative complications, and the standardized operation is a key factor in the prevention of complications.
Key words:
Epilepsy; Child; Vagus nerve stimulation; Postoperative complications; Refractory
Contributor Information
Chen Shuai
Department of Functional Neurosurgery, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Epilepsy Center, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Xie Zihang
Department of Functional Neurosurgery, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Epilepsy Center, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Deng Jie
Epilepsy Center, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Department of Neurology, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Zheng Lili
Epilepsy Center, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Department of Neurology, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Chen Chunhong
Epilepsy Center, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Department of Neurology, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Wang Xiaofei
Epilepsy Center, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Department of Neurology, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Ding Changhong
Epilepsy Center, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Department of Neurology, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Chen Feng
Department of Functional Neurosurgery, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Epilepsy Center, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Fang Fang
Epilepsy Center, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Department of Neurology, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Fang Tie
Department of Functional Neurosurgery, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
Epilepsy Center, Beijing Children′s Hospital, Capital Medical University, National Children′s Medical Center, Beijing 100045, China
