难治性癫痫患儿迷走神经刺激诱发睡眠呼吸障碍的患病率：一项回顾性队列研究

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2025-08-29 DOI:10.1016/j.sleep.2025.106790

Rahul Verma , Haley Fishman , Puneet Jain , Lyndsey McRae , Kaitlin Flynn , Ivanna Yau , Cristina Go , Indra Narang , Jackie Chiang , Sundeep Bola , James Rutka , George Ibrahim , Reshma Amin

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引用次数: 0

摘要

理性外泄神经刺激器（VNS）可以减轻儿童癫痫发作负担，但可能导致睡眠呼吸障碍（SDB）。我们的目的是利用多导睡眠描图（PSG）评估VNS植入前后癫痫患儿SDB的患病率，并探讨VNS诱发SDB的治疗策略。方法回顾性队列研究于2019年5月至2024年9月在加拿大多伦多病童医院对0-18岁难治性癫痫和VNS插入患儿进行研究。所有纳入的儿童在植入VNS前1年内接受了1级基线PSG评估。一旦植入VNS，在18个月内进行重复PSG。配对t检验和wilcoxon配对对检验比较了插入VNS前后psg的呼吸变量。结果共纳入27例患儿，平均（SD）年龄为8.8（4.2）岁。在VNS插入之前，5名（19%）儿童患有轻度阻塞性睡眠呼吸暂停（OSA）， 1名（4%）儿童患有中度阻塞性睡眠呼吸暂停（OSA），没有儿童患有重度OSA， 2名（7%）儿童患有中枢性睡眠呼吸暂停（CSA）， 1名（4%）儿童患有夜间低通气。在植入VNS后，9名（33%）儿童经历了SDB恶化，其中大多数从没有OSA发展为轻度OSA。VNS诱发的SDB的治疗策略包括保守治疗、改变VNS设置、腺扁桃体切除术和持续气道正压治疗。结论经VNS治疗的癫痫患儿OSA的严重程度可能增加。所有被认为有VNS的儿童都应常规筛查SDB的症状。针对vns诱发的SDB，可以采用多种管理策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

$The prevalence of vagus nerve stimulator-induced sleep disordered breathing in children with refractory Epilepsy: A retrospective cohort study$

查看原文本刊更多论文

The prevalence of vagus nerve stimulator-induced sleep disordered breathing in children with refractory Epilepsy: A retrospective cohort study

Rationale

Vagus nerve stimulators (VNS) can reduce seizure burden in children but may result in sleep-disordered breathing (SDB). Our objectives were to assess the prevalence of SDB in children with epilepsy using polysomnography (PSG) before and after VNS implantation as well to explore management strategies for VNS-induced SDB.

Methods

A retrospective cohort study was conducted (May 2019 to September 2024) of children aged 0–18 years old with refractory epilepsy and VNS insertion at The Hospital for Sick Children, Toronto, Canada. All included children underwent level 1 baseline PSG evaluation within 1 year prior to VNS insertion. Once VNS was inserted, a repeat PSG was conducted within 18 months. Paired t-tests and Wilcoxon-matched-pair tests compared respiratory variables from PSGs before and after VNS insertion.

Results

Twenty-seven children with a mean (SD) age of 8.8 (4.2) years were included. Prior to VNS insertion, 5 (19 %) children had mild obstructive sleep apnea (OSA), 1 (4 %) child had moderate OSA, no child had severe OSA, 2 (7 %) children had central sleep apnea (CSA), and 1 (4 %) child had nocturnal hypoventilation. After VNS insertion, 9 (33 %) children experienced worsened SDB, with most progressing from having no OSA to developing mild OSA. Management strategies for VNS-induced SDB included conservative management, alteration of VNS settings, adenotonsillectomy, and continuous positive airway pressure therapy.

Conclusions

The severity of OSA may increase in children with epilepsy treated with VNS. All children being considered for VNS should be routinely screened for symptoms of SDB. Various management strategies can be used for VNS-induced SDB are available.

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.