Document Type

Article

Publication Date

5-6-2025

Comments

This article is the author’s final published version in Epilepsy & Behavior Reports Volume 31, September 2025, Article number 100778.

The published version is available at https://doi.org/10.1016/j.ebr.2025.100778. Copyright © 2025 The Authors. Published by Elsevier Inc.

Abstract

Vagus nerve stimulation (VNS) can be a highly effective treatment option for patients with drug resistant epilepsy. Notably, VNS has demonstrated side effects including a unique form of sleep disordered breathing known as vagus nerve stimulator associated sleep disordered breathing (VaS). However, the ways in which VaS interacts with seizure frequency is unknown. We report a case of a 28-year-old woman who presented to our department with complaints of worsening sleep quality 3 years following VNS implantation. Upon polysomnographic (PSG) evaluation, it was discovered that she suffered from VaS. The patient’s VNS output current was then down titrated during a subsequent PSG resulting in resolution of her VaS. Interestingly, despite downward titration of her nighttime VNS output current, the patient demonstrated a prolonged seizure free period, highlighting the complex interactions between VNS, VaS and seizure frequency. In cases where patients present with both epilepsy and VaS, physicians should be aware of this complex relationship. Further, this case highlights that down titration of VNS settings may result in not just improvement in VaS but may also result in improvement in seizure frequency.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Language

English

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