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18.08.2020 | Case Report - Functional Neurosurgery - Epilepsy

VNS implantation in a NF1 patient: massive nerve hypertrophy discovered intra-operatively preventing successful electrode placement. Case report

verfasst von: Hussein Hamdi, Gilles Brun, Marc Zanello, Maxine Dibué, Yassine Beltaifa, Stanislas Lagarde, Agnes Trébuchon, Fabrice Bartolomei, Romain Carron

Erschienen in: Acta Neurochirurgica | Ausgabe 10/2020

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Abstract

For the vast majority of surgeons, no specific investigation is necessary before vagal nerve stimulation (VNS) implantation. We report our intraoperative unexpected finding of a massively enlarged vagus nerve in a patient with neurofibromatosis type 1 (NF1). The nerve hypertrophy prevented wrapping the coils of the helical electrode. The patient had no signs of vagus nerve dysfunction preoperatively (no hoarseness or dysphonia). This exceptional mishap is undoubtedly related to NF1-associated peripheral nerve sheath tumors. Even though it is not advisable to routinely perform any imaging prior to VNS, in such specific context, preoperative imaging work-up, especially cervical ultrasound, might be judicious to rule out any asymptomatic enlarged left vagus nerve.

Al Omari AI, Alzoubi FQ, Alsalem MM, Aburahma SK, Mardini DT, Castellanos PF (2017) The vagal nerve stimulation outcome, and laryngeal effect: otolaryngologists roles and perspective. Am J Otolaryngol 38(4):408–413CrossRef

Anand IS, Konstam MA, Klein HU et al (2020) Comparison of symptomatic and functional responses to vagus nerve stimulation in ANTHEM-HF, INOVATE-HF, and NECTAR-HF. ESC Heart Fail 7(1):75–83PubMedPubMedCentral

Anil G, Tan T-Y (2011) CT and MRI evaluation of nerve sheath tumors of the cervical vagus nerve. AJR Am J Roentgenol 197(1):195–201CrossRef

Ben-Menachem E, Hellström K, Waldton C, Augustinsson LE (1999) Evaluation of refractory epilepsy treated with vagus nerve stimulation for up to 5 years. Neurology 52(6):1265–1267CrossRef

Bonaz B, Sinniger V, Hoffmann D et al (2016) Chronic vagus nerve stimulation in Crohn’s disease: a 6-month follow-up pilot study. Neurogastroenterol Motil 28(6):948–953CrossRef

Bottomley JM, LeReun C, Diamantopoulos A, Mitchell S, Gaynes BN (2019) Vagus nerve stimulation (VNS) therapy in patients with treatment resistant depression: a systematic review and meta-analysis. Compr Psychiatry 98:152156CrossRef

Bray DP, Chan AK, Chin CT, Jacques L (2016) Large cervical vagus nerve tumor in a patient with neurofibromatosis type 1 treated with gross total resection: case report and review of the literature. J Brachial Plex Peripher Nerve Inj 11(1):e48–e54CrossRef

Cartwright MS, Passmore LV, Yoon J-S, Brown ME, Caress JB, Walker FO (2008) Cross-sectional area reference values for nerve ultrasonography. Muscle Nerve 37(5):566–571CrossRef

Chen H-H, Chen T-C, Yang T-L, Wang C-P (2019) Transcutaneous sonography for detection of the cervical vagus nerve. Ear Nose Throat J. https://doi.org/10.1177/0145561319875432

10.

Englot DJ, Chang EF, Auguste KI (2011) Vagus nerve stimulation for epilepsy: a meta-analysis of efficacy and predictors of response. J Neurosurg 115(6):1248–1255CrossRef

11.

Giovagnorio F, Martinoli C (2001) Sonography of the cervical vagus nerve: normal appearance and abnormal findings. AJR Am J Roentgenol 176(3):745–749CrossRef

12.

Gutmann DH, Ferner RE, Listernick RH, Korf BR, Wolters PL, Johnson KJ (2017) Neurofibromatosis type 1. Nat Rev Dis Primers 3:17004CrossRef

13.

Hamdi H, Spatola G, Lagarde S, McGonigal A, Paz-Paredes A, Bizeau A, Bartolomei F, Carron R (2019) Use of polyvinyl alcohol sponge cubes for vagal nerve stimulation: a suggestion for the wrapping step. Technical Note and Step-by-Step Operative Technique. Oper Neurosurg (Hagerstown). https://doi.org/10.1093/ons/opz227

14.

Hammer N, Löffler S, Cakmak YO, Ondruschka B, Planitzer U, Schultz M, Winkler D, Weise D (2018) Cervical vagus nerve morphometry and vascularity in the context of nerve stimulation—a cadaveric study. Sci Rep 8(1):7997CrossRef

15.

Johnson RL, Wilson CG (2018) A review of vagus nerve stimulation as a therapeutic intervention. J Inflamm Res 11:203–213CrossRef

16.

Kahlow H, Olivecrona M (2013) Complications of vagal nerve stimulation for drug-resistant epilepsy: a single center longitudinal study of 143 patients. Seizure 22(10):827–833CrossRef

17.

Kerasnoudis A, Tsivgoulis G (2015) Nerve ultrasound in peripheral neuropathies: a review. J Neuroimaging 25(4):528–538CrossRef

18.

Knappertz VA, Tegeler CH, Hardin SJ, McKinney WM (1998) Vagus nerve imaging with ultrasound: anatomic and in vivo validation. Otolaryngol Head Neck Surg 118(1):82–85CrossRef

19.

Lee JH, Cheng K-L, Choi YJ, Baek JH (2017) High-resolution imaging of neural anatomy and pathology of the neck. Korean J Radiol 18(1):180–193CrossRef

20.

Martin JLR, Martín-Sánchez E (2012) Systematic review and meta-analysis of vagus nerve stimulation in the treatment of depression: variable results based on study designs. Eur Psychiatry 27(3):147–155CrossRef

21.

McGregor A, Wheless J, Baumgartner J, Bettis D (2005) Right-sided vagus nerve stimulation as a treatment for refractory epilepsy in humans. Epilepsia 46(1):91–96CrossRef

22.

Navas M, Navarrete EG, Pascual JM, Carrasco R, Núñez JA, Shakur SF, Pastor J, Sola RG (2010) Treatment of refractory epilepsy in adult patients with right-sided vagus nerve stimulation. Epilepsy Res 90(1–2):1–7CrossRef

23.

Pelz JO, Belau E, Henn P, Hammer N, Classen J, Weise D (2018) Sonographic evaluation of the vagus nerves: protocol, reference values, and side-to-side differences. Muscle Nerve 57(5):766–771CrossRef

24.

Planitzer U, Hammer N, Bechmann I, Glätzner J, Löffler S, Möbius R, Tillmann BN, Weise D, Winkler D (2017) Positional relations of the cervical vagus nerve revisited. Neuromodulation 20(4):361–368CrossRef

25.

Shaw GY, Sechtem P, Searl J, Dowdy ES (2006) Predictors of laryngeal complications in patients implanted with the Cyberonics vagal nerve stimulator. Ann Otol Rhinol Laryngol 115(4):260–267CrossRef

26.

Spuck S, Nowak G, Renneberg A, Tronnier V, Sperner J (2008) Right-sided vagus nerve stimulation in humans: an effective therapy? Epilepsy Res 82(2–3):232–234CrossRef

27.

Zaidman CM, Al-Lozi M, Pestronk A (2009) Peripheral nerve size in normals and patients with polyneuropathy: an ultrasound study. Muscle Nerve 40(6):960–966CrossRef

Titel: VNS implantation in a NF1 patient: massive nerve hypertrophy discovered intra-operatively preventing successful electrode placement. Case report
verfasst von: Hussein Hamdi
Gilles Brun
Marc Zanello
Maxine Dibué
Yassine Beltaifa
Stanislas Lagarde
Agnes Trébuchon
Fabrice Bartolomei
Romain Carron
Publikationsdatum: 18.08.2020
Verlag: Springer Vienna
Erschienen in: Acta Neurochirurgica / Ausgabe 10/2020
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-020-04535-y

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