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We present the case of a 12-year-old girl with medically refractory epilepsy and a vagal nerve stimulator (VNS), who experienced severe obstructive sleep apnea (OSA) with respiratory events closely matching her VNS settings. We demonstrated a real-time decrease in OSA through an in-laboratory VNS titration study, decreasing her VNS frequency from 20 Hz to 10 Hz. We were able to demonstrate a baseline level of OSA by turning off the VNS. We then effectively treated her residual OSA with continuous positive airway pressure (CPAP). Novel to our case is that this in-laboratory VNS titration did not result in any subsequent increase in seizure frequency. After 5 months, her seizure frequency had decreased. Our case demonstrates that in-laboratory VNS titration can be an efficient tool for optimizing treatment of VNS-induced OSA and assert that polysomnography before VNS placement is important for guiding future care.
This article was published in the following journal.
Name: Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
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Neurology - Central Nervous System (CNS)
Alzheimer's Disease Anesthesia Anxiety Disorders Autism Bipolar Disorders Dementia Epilepsy Multiple Sclerosis (MS) Neurology Pain Parkinson's Disease Sleep Disorders Neurology is the branch of me...