• Journal of Trauma and Injury
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• v.35 no.2
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• pp.115-117
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• 2022

"Whiplash"-type injuries are commonly encountered and often cause neck pain, neck stiffness, and headaches. However, these injuries can have rare and poorly recognized complications, such as the development of a prevertebral hematoma leading to acute respiratory failure in the emergency department, followed by severe, life-threatening dysphagia and recurrent aspirations. In the patient described herein, a whiplash injury was accompanied by vocal cord paralysis and dysphonia (vagus nerve), dysgeusia (glossopharyngeal nerve, vagus nerve), and upper esophageal spasm (cricopharyngeal muscle, vagus nerve). It is unlikely that this was a complication of cervical fusion surgery. Instead, a combined stretch-induced lower cranial nerve injury, possibly on the exit of these nerves through the jugular foramen, seems to be a likely, but underappreciated mechanism occurring in rare instances of whiplash injuries.

• Journal of Korean Neurosurgical Society
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• v.62 no.3
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• pp.344-352
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• 2019

Epilepsy is one of the major chronic neurological diseases affecting many patients. Resection surgery is the most effective therapy for medically intractable epilepsy, but it is not feasible in all patients. Vagus nerve stimulation (VNS) is an adjunctive neuromodulation therapy that was approved in 1997 for the alleviation of seizures; however, efforts to control epilepsy by stimulating the vagus nerve have been studied for over 100 years. Although its exact mechanism is still under investigation, VNS is thought to affect various brain areas. Hence, VNS has a wide indication for various intractable epileptic syndromes and epilepsy-related comorbidities. Moreover, recent studies have shown anti-inflammatory effects of VNS, and the indication is expanding beyond epilepsy to rheumatoid arthritis, chronic headaches, and depression. VNS yields a more than 50% reduction in seizures in approximately 60% of recipients, with an increase in reduction rates as the follow-up duration increases. The complication rate of VNS is 3-6%, and infection is the most important complication to consider. However, revision surgery was reported to be feasible and safe with appropriate measures. Recently, noninvasive VNS (nVNS) has been introduced, which can be performed transcutaneously without implantation surgery. Although more clinical trials are being conducted, nVNS can reduce the risk of infection and subsequent device failure. In conclusion, VNS has been demonstrated to be beneficial and effective in the treatment of epilepsy and various diseases, and more development is expected in the future.

• Annals of Clinical Neurophysiology
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• v.16 no.1
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• pp.42-44
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• 2014

• Journal of Korean Medicine Rehabilitation
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• v.34 no.1
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• pp.65-81
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• 2024

Objectives This study aimed to understand the general research trends, applicated disease, and methodology of transcutaneous/percutaneous vagus nerve stimulation, contemplating its clinical use in traditional Korean medicine and future research directions. Methods A scoping review was conducted following Arksey and O'Malley Framework Stage and adhering to the PRISMA extension for scoping reviews: checklist and explanation. Papers published until October 30, 2023, were investigated across 10 databases (PubMed, Embase, Scopus, Web of Science, China National Knowledge Infrastructure, Oriental Medicine Advanced Searching Integrated System, Korean Studies Information Service System, KMbase, Science ON, Research Information Sharing Service. The search terms used were 'Transcutaneous/Percutaneous vagus nerve stimulation'. Results Since 2021, the application of transcutaneous/percutaneous vagus nerve stimulation for musculoskeletal symptoms has been actively researched, predominantly in Asia (37%), Europe (37%), and North America (21%). All 19 papers were part of clinical studies. Chronic pain was noted that most applied disease, it also was found to potentially aid in acute post-surgical pain relief. Major assessment tools include not only simple pain metrics but also pain perception, vagal nerve tension, quality of life, and inflammatory markers. Most procedures were carried out through the ear, which offers a favorable site for therapeutic stimulation without notable side effects. And parameter analysis, frequencies typically ranged around 25 Hz to 30 Hz, while pulse widths were commonly set at 250 ㎲ or 300 ㎲. Conclusions Transcutaneous/percutaneous vagus nerve stimulation is easily accessible through acupuncture in Korean medicine. Therefore, if future studies establish parameters and clinical significance, it could be utilized as a therapeutic modality.

• The Journal of Internal Korean Medicine
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• v.44 no.3
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• pp.455-465
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• 2023

Inflammatory bowel disease (IBD) is defined as a chronic inflammatory-mediated disease that causes ulceration and inflammation in the gastrointestinal tract. Among most patients, the course of chronic inflammation repeatedly shows intermittent exacerbations and alternating remissions. However, despite the various therapeutic options to relieve symptoms, such as corticosteroids, TNF-α inhibitors, and antibiotic drugs, there is no known cure for IBD. Nonetheless, previous research has revealed that the autonomic nervous system is involved in the pathophysiology of IBD. In this study, we reviewed clinical trials confirming the therapeutic effect of vagus nerve stimulation (VNS) on IBD in vivo. We searched in vivo and human studies on Pubmed using keywords combined with "vagus nerve stimulation", "VNS", and "inflammatory bowel disease". All studies included in this review reported that direct VNS is effective in relieving symptoms of IBD and has no severe adverse effects. The most frequently stimulated site was the unilateral cervical vagus nerve area, and parameters for stimulation were set as 5-20 Hz. Based on the results, we aim to summarize the evidence for the efficacy of VNS on IBD and suggest the possibility of auricular electroacupuncture treatment as a therapeutic option for IBD.

• The Korean Journal of Physiology
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• v.6 no.2
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• pp.31-37
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• 1972

The right cervical vagus nerve was electrically stimulated for 30 sec, and 30 minutes recording cardiac rate responses and electrocardiogram. The main purposes of the present experiment are to determine effect of stimulation frequency on the maintenance of cardiac rate responses and to determine recovery time of sinus rhythm after asystole period followed by idioventricular rhythm during prolonged electrical stimulation of the vagus, and the optimal stimulation parameters for vagal stimulation were studied as well. The results obtained are summarized as follows: 1. The maximum negative chrontropic responses were obtained with the following ranges of electrical parameters. Intensity: 3V-7V, Frequency: 20/sec-60/sec, and pulse duration: 5 msec-20 msec. 2. Compared with the responses from sympathetic effectors, cardiac rate responses to electrical stimulation of vagus nerve were well maintained with all stimulation frequencies. 3. At all stimulation frequencies except 20/sec, sinus node started to take over primary pacemaker activity when cardiac rates were restored to about 38-40/min. 4. It was indicated that upper limit of idioventricular rhythm does not exceed 38-40/min. 5. With the stimulation parameter set of 20/sec-5 msec-3 V, sinus rhythm did not appear during 30 minutes of stimulation period. Therefore, this electrical parameter set appears to be optimal for elicitation of prolonged and maximum cardiac rate responses by vagal stimulation.

• Journal of Korean Neurosurgical Society
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• v.54 no.5
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• pp.423-425
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• 2013

We present a case report to remind surgeons of this unusual complication that can occur in any surgery, even posterior cervical spine surgery under general anesthesia and discuss its causes, treatment methods, and the follow-up results in the literature. The peripheral Tapia's syndrome is a rare complication of anesthetic airway management. Main symptoms are hoarseness of voice and difficulty of tongue movement. Tapia's syndrome after endotracheal general anesthesia is believed to be due to pressure neuropathy of the vagus nerve and the hypoglossal nerve caused by the endotracheal tube. To our knowledge, no report has been published or given an explanation for Tapia's syndrome after posterior cervical spine surgery. Two patients who underwent posterior cervical surgery complained hoarseness and tongue palsy postoperatively. There is no direct anatomical relation between the operation, the vagus nerves and the hypoglossal nerves, and there is no record of displacement or malposition of the endotracheal tube. After several months, all symptoms are resolved. To avoid this problem in posterior cervical spine surgery, we suggest paying special attention to the position of the endotracheal tube to avoid excessive neck flexion before and during the positioning of the patient.

• Korean Journal of Clinical Laboratory Science
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• v.39 no.1
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• pp.56-62
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• 2007

Lennox-Gastaut syndrome(LGS) is a severe age-specific epilepsy syndrome that causes medication-resistant seizures in childhood. Vagal nerve stimulation (VNS) has been proposed as a possible way to improve the treatment of refractory epilepsy. We treated 9 patients with Lennox-Gastaut syndrome between the ages of 2 and 11 years (mean 5.8 years), by using the vagus nerve stimulation. The mean follow-up duration was 35 months. The mean reduction of seizure frequency compared with baseline before VNS was 52% after 6 months (range, 0% to 89%; P<0.011), and 58% after 1 year (range 0% to 89%; P<0.012). Seven patients showed improvements of quality of life (QOL) such as alertness, mood, and language skills. The most common side effects were transient hoarseness (6 patients) and drooling (1 patient). Our results suggest that the vagus nerve stimulation could be an effective and safe adjunct therapy for the treatment of Lennox-Gastaut syndrome.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.2
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• pp.81-97
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• 2021

Objectives This study was designed to identify the changes of autonomic nervous system (ANS) which was induced by acupuncture at the field of the auricular branch of the vagus nerve. Methods 30 healthy adults were selected and classified into two groups; experimental group, control group. After providing mental stress, acupuncture was applied at external ear in experimental group and no treatment executed in control group. The evaluation of ANS function was measured by heart rate variability (HRV). We statically analyzed the difference of HRV parameters which include mean heart rate (MHRT), standard deviation of all N-N intervals (SDNN), square root of the mean of the sum of the squares of differences between adjacent N-N intervals (RMSSD), total power (TP), low frequency power (LF), high frequency power (HF), LF/HF ratio. Results All subjects showed significant increase in SDNN, LF after stress stimulation (p<0.05). Immediately after intervention, MHRT was significantly decreased (p<0.001) and RMSSD, HF were significantly increased in experimental group (p<0.05). After the end of intervention, SDNN, HF, RMSSD, TP, LF were significantly increased in experimental group (p<0.01, p<0.05). And when comparing baseline HRV, SDNN, LF were significantly increased in control group (p<0.01) and SDNN, RMSSD, TP, LF were significantly increased in experimental group (p<0.05). In the subgroup analysis, normal balance of ANS group showed significant increase in TP, LF, SDNN, HF (p<0.01, p<0.05). Conclusions We suggested that acupuncture at external ear, region of the vagus nerve distribution could increase parasympathetic activity and cause changes and reregulation of the ANS.

• Korean Journal of Head & Neck Oncology
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• v.16 no.2
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• pp.224-227
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• 2000

Neurilemmomas are benign nerve sheath tumors arising from peripheral Schwann cells. The tumor composed of Schwann cells and collagen fibers, can occur in any region of the body where there is a nerve that has a Schwann sheath. The incidence of the tumor in the head and neck is about 30% with many of these occurring on the vagus nerve. Neurilemmoma is characterized by solitary occurrence, with sharp demarcation and encapsulation. Multiple genesis is very rare. This article presents a rare case of multiple neurilemmomas located bilaterally in the cervical region.