{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T15:07:05Z","timestamp":1790435225567,"version":"4.1.0"},"reference-count":41,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:p content-type=\"fine-print\">\n                    <jats:italic>Object.<\/jats:italic>\n                    The aim of this study was to define better the incidence of surgical complications and untoward side effects of chronic vagus nerve stimulation (VNS) in a population of children with medically refractory epilepsy.\n                  <\/jats:p>\n                  <jats:p content-type=\"fine-print\">\n                    <jats:italic>Methods.<\/jats:italic>\n                    The authors retrospectively reviewed the cases of 74 consecutive patients (41 male and 33 female) 18 years of age or younger (mean age 8.8 years, range 11 months\u201318 years) who had undergone implantation of a vagal stimulator between 1998 and 2001 with a minimum follow up of 1 year (mean 2.2 years). Of the 74 patients treated, seven (9.4%) had a complication ultimately resulting in removal of the stimulator. The rate of deep infections necessitating device removal was 3.5% (three of 74 patients who had undergone 85 implantation and\/or revision procedures). An additional three superficial infections occurred in patients in whom the stimulators were not removed: one was treated with superficial operative debridement and antibiotic agents and the other two with oral antibiotics only. Another four stimulators (5.4%) were removed because of the absence of clinical benefit and device intolerance. Two devices were revised because of lead fracture (2.7%). Among the cohort, 11 battery changes have been performed thus far, although none less than 33 months after initial implantation. Several patients experienced stimulation-induced symptoms (hoarseness, cough, drooling, outbursts of laughter, shoulder abduction, dysphagia, or urinary retention) that did not require device removal. Ipsilateral vocal cord paralysis was identified in one patient. One patient died of aspiration pneumonia more than 30 days after device implantation.\n                  <\/jats:p>\n                  <jats:p content-type=\"fine-print\">\n                    <jats:italic>Conclusions.<\/jats:italic>\n                    Vagus nerve stimulation remains a viable option for improving seizure control in difficult to treat pediatric patients with epilepsy. Surgical complications such as hardware failure (2.7%) or deep infection (3.5%) occurred, resulting in device removal or revision. Occasional stimulation-induced symptoms such as hoarseness, dysphagia, or torticollis may be expected (5.4%).\n                  <\/jats:p>","DOI":"10.3171\/jns.2003.99.3.0500","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T13:51:10Z","timestamp":1242222670000},"page":"500-503","source":"Crossref","is-referenced-by-count":132,"title":["Complications of chronic vagus nerve stimulation for epilepsy in children"],"prefix":"10.3171","volume":"99","author":[{"given":"Matthew D.","family":"Smyth","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Shane","family":"Tubbs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Martina","family":"Bebin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Grabb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P.","family":"Blount","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Child Neurol","first-page":"S29","article-title":"Intrathecal baclofen in cerebral palsy movement disorders.","volume":"11","author":"Albright","year":"1996"},{"key":"b2","series-title":"Neurology","first-page":"224","article-title":"A randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures. The Vagus Nerve Stimulation Study Group.","volume":"45","year":"1995"},{"key":"b3","series-title":"J Neurophysiol","first-page":"405","article-title":"A sensory cortical representation of the vagus nerve. 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Report of two cases.","volume":"96","author":"Kalkanis","year":"2002"},{"key":"b20","series-title":"Pacing Clin Electrophysiol","first-page":"1581","article-title":"Neurocardiac responses to vagoafferent electrostimulation in humans.","volume":"15","author":"Kamath","year":"1992"},{"key":"b21","series-title":"Neurosurgery","first-page":"426","article-title":"Vagus nerve stimulation activates central nervous system structures in epileptic patients during PET H215O blood flow imaging.","volume":"39","author":"Ko","year":"1996"},{"key":"b22","series-title":"Neurology","first-page":"S34","article-title":"Deep brain stimulation of the globus pallidus pars interna in advanced Parkinson's disease.","volume":"55","author":"Kumar","year":"2000"},{"key":"b23","series-title":"J Neurosurg","first-page":"26","article-title":"Vagus nerve stimulation for complex partial seizures: surgical technique, safety, and efficacy.","volume":"78","author":"Landy","year":"1993"},{"key":"b24","series-title":"Pediatr Neurosurg","first-page":"164","article-title":"Interscapular placement of a vagal nerve stimulator pulse generator for prevention of wound tampering. 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The Pediatric VNS Study Group.","volume":"134","author":"Murphy","year":"1999"},{"key":"b29","series-title":"Pediatr Neurol","first-page":"167","article-title":"Left vagal nerve stimulation in six patients with hypothalamic hamartomas.","volume":"23","author":"Murphy","year":"2000"},{"key":"b30","series-title":"Pacing Clin Electrophysiol","first-page":"1572","article-title":"Chronic vagus nerve stimulation increases the latency of the thalamocortical somatosensory evoked potential.","volume":"15","author":"Naritoku","year":"1992"},{"key":"b31","series-title":"Harefuah","first-page":"5","article-title":"[Vagus nerve stimulation for partial seizures.]","volume":"129","author":"Neufeld","year":"1995"},{"key":"b32","series-title":"Neurosurgery","first-page":"1353","article-title":"Efficacy of vagal nerve stimulation in children with medically refractory epilepsy.","volume":"47","author":"Patwardhan","year":"2000"},{"key":"b33","series-title":"Epilepsia","first-page":"S40","article-title":"Prevention of intractable partial seizures by intermittent vagal stimulation in humans: preliminary results.","volume":"31","author":"Penry","year":"1990"},{"key":"b34","series-title":"Brain Res","first-page":"1","article-title":"Anatomical evidence of direct projections from the nucleus of the solitary tract to the hypothalamus, amygdala, and other forebrain structures in the rat.","volume":"153","author":"Ricardo","year":"1978"},{"key":"b35","series-title":"Epilepsia","first-page":"S1","article-title":"Anatomical, physiological, and theoretical basis for the antiepileptic effect of vagus nerve stimulation.","volume":"31","author":"Rutecki","year":"1990"},{"key":"b36","series-title":"Epilepsia","first-page":"299","article-title":"Vagus nerve stimulation has no effect on awake EEG rhythms in humans.","volume":"34","author":"Salinsky","year":"1993"},{"key":"b37","series-title":"Pediatr Neurosurg","first-page":"99","article-title":"Histological appearance of a chronically stimulated vagus nerve in a pediatric patient.","volume":"35","author":"Tubbs","year":"2001"},{"key":"b38","series-title":"Epilepsia","first-page":"S44","article-title":"Efficacy and safety of vagus nerve stimulation in patients with complex partial seizures.","volume":"31","author":"Uthman","year":"1990"},{"key":"b39","series-title":"Epilepsia","first-page":"S7","article-title":"Effects of vagal stimulation on experimentally induced seizures in rats.","volume":"31","author":"Woodbury","year":"1990"},{"key":"b40","series-title":"Pacing Clin Electrophysiol","first-page":"94","article-title":"Vagal stimulation reduces the severity of maximal electroshock seizures in intact rats: use of a cuff electrode for stimulating and recording.","volume":"14","author":"Woodbury","year":"1991"},{"key":"b41","series-title":"Electroencephalogr Clin Neurophysiol","first-page":"357","article-title":"The effect of vagal afferent stimulation on the EEG pattern of the cat.","volume":"4","author":"Zanchetti","year":"1952"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/99\/3\/article-p500.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/99\/3\/article-p500.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/99\/3\/article-p500.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,19]],"date-time":"2023-03-19T19:36:03Z","timestamp":1679254563000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/99\/3\/article-p500.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,9]]},"references-count":41,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/jns.2003.99.3.0500","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[2003,9]]}}}