• Title/Summary/Keyword: Vagus nerve

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Effects of Vagus Nerve Stimulation on Adults and Children with Refractory Epilepsy (소아와 성인의 난치성 간질 환자에서 미주신경 자극술의 효과)

  • Kim, Cheon-Sik;Ro, Yeong-Joo;Choi, Sang-Yong;Kim, Dae-Sik
    • Korean Journal of Clinical Laboratory Science
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    • v.38 no.2
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    • pp.141-146
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    • 2006
  • Vagal nerve stimulation (VNS) has been proposed as a possible way to improve the control of refractory epilepsy. We report the effects following VNS treatment in patients with refractory epilepsy. Seventeen patients with a mean age of 12.8 years, ranging from 5 to 29 years, underwent the implantation of vagal nerve stimulation (Cyberonics, Houston, TX). We reviewed the clinical findings before and after VNS in seizure frequency, number of antiepileptic drugs (AED), and quality of life (QOL). All of the patients had intractable seizures, eleven of the patients had additional medical complications, three had hippocampus atrophy, one had encephalomalacia, five had encephalitis, one had pachygyria, and one had schizencephaly. Thirteen patients had symptomatic partial epilepsies, three patients had Lennox-Gastaut syndrome and one had cryptogenic partial epilepsy. The mean follow up duration was 35 months. The mean reduction of seizure frequency compared with baseline before VNS was 26.1% after 3 months (p<0.005), 41.9% after 6 months (p<0.001), 46.9% after 1 year (p<0.001), and 53% at the latest follow-up (p<0.001). Twelve patients showed an improvement of QOL such as mood, language, alertness, expression, and motor function. The most common side effects were transient hoarseness or voice change or cough, which was detected in six patients (35%) and wound infection in one patient (5%). This study has shown a good anti-seizure effect of VNS, decrease in seizure frequency and improvements in QOL. We concluded that VNS is a beneficial therapy in refractory epilepsy with a non-resectable epileptic focus. Further studies should be focused on the prediction of unresponsiveness and the adjustment of VNS parameters for maximum efficacy in patients with various medical histories.

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Laryngeal Evoked Electromyography with a Noninvasive Technique (비침습적 방법에 의한 후두유발근전도 검사)

  • 정성민;조선희;박기덕
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.10 no.1
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    • pp.30-36
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    • 1999
  • Background and Objectives : Laryngeal Evoked Electromyography(EEMG) is a objective, quantitative technique to determine innervation status of larynx. The possible applications of this technique are to confirm the etiology of impaired vocal fold motion and monitor perioperative vagus nerve trauma. The purpose of this study is to develop a novel method for determining the amount of reinnervation of recurrent laryngeal nerve with accurate, inexpensive, and minimally invasive technique in human. Materials and Methods : Laryngeal EEMG was performed for 16 adults with intact vocal folds motion and 2 patients diagnosed as unilateral vocal fold paralysis. for the purpose of searching what is the optimal and noninvasive technique for laryngeal EEMG, we used 2 types of stimulation configurations(transcutaneous vs percutaneous) and 2 types of recording configurations(intramuscular vs. surface). Results and Conclusions : Percutaneous needle stimulation and surface recording of laryngeal EEMG was reliable and comparable to standard needle stimulation and invasive intramuscular needle recording. But the laryngeal EEMG by the surface recording and transcutaneous surface stimulation was not reliable and repeatable. Therefore we recommended that laryngeal EEMG by surface recording and percutaneous needle stimulation would be minimally invasive, reliable technique to know the status of reinnervation in e patients with vocal fold paralysis.

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Cervical Epidural Block Can Relieve Persistent Hiccups -Case report- (경부 경막외 신경차단을 이용한 2주간 계속된 딸꾹질의 치료 경험 -증례보고-)

  • Lee, Kyung-Jin;Park, Won-Sun;Chun, Tae-Wan;Kim, Chan;Nam, Yong-Taek
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.131-134
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    • 1995
  • Hiccup is characterized by a myoclonus in the diaphragm, resulting in a sudden inspiration associated with an audible closure of the glottis. The reflex arc in hiccups comprises three pars: an afferent, a central and an efferent part. The afferent portion of the neural pathway of hiccup formation is composed of the vagus nerve, the phrenic nerve, and the sympathetic chain arising from T6 to T12. The hiccup center is localised in the brain stem and the efferent limb comprises phrenic pathways. All stimuli affecting the above mentioned reflex arc may produce hiccups. The pathogenesis of persistent hiccups is not known. Hiccup can present a symptom of a subphrenic abscess or gastric distention, and metabolic alterations may also cause hiccups. Numerous treatment modalities have been tried but with questionable success. We describe a patient whose persistant hiccups was treated successfully by a cervical epidural block.

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Paraganglioma of the Submandibular Region (악하선 부위에 발생한 부신경절종)

  • Kim, Jae Gu;Hong, A Ram;Kim, Jo Heon;Lee, Dong Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.36 no.2
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    • pp.51-53
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    • 2020
  • Paraganglioma is a rare benign neuroendocrine tumor arising from the paraganglia of the autonomic nervous system. Paraganglioma occurs mainly in the carotid body, jugular foramen, and vagus nerve in the head and neck region. Herein, we report a case of paraganglioma of the submandibular region that has not been reported. This case highlights paraganglioma as a rare differential diagnosis for submandibular region tumors.

A CASE REPORT OF MEDIASTINITIS FROM ODONTOGENIC INFECTION (치성감염에서 기원한 종격염의 치험례)

  • Bang, Seok-Jun;Hwang, Jae-Hong;Lee, Seung-Yeop;Lee, Chang-Jin;Jeon, In-Seong;Yun, Gyu-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.4
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    • pp.399-405
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    • 1997
  • Mediastinum is the space located between the right & left lung lobes in the center of the thorax, and contains many vital organs such as heart, aorta, trachea, esophagus, vagus nerve, lymphatics. So the infection of mediastinal space causes a serious and potentially fatal process. Like other infections, surgical drainage, aggressive antibiotic therapy and supportive care are recommended for optimal outcome. Airway management in the presence of the neck, glottic edema, elevation of the tongue is a formidible problem especially in the case from odontogenic origin. We have recently encountered such a case resulting in a number of local and systemic complications.

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Reflux Following Esophagectomy for Esophageal Cancer

  • Cho, Jong Ho
    • Journal of Chest Surgery
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    • v.53 no.4
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    • pp.217-221
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    • 2020
  • Gastroesophageal reflux is a common problem after gastroesophageal resection and reconstruction, despite the routine prescription of proton pump inhibitors (PPIs). Resection of the lower esophageal sphincter and excision of the vagus nerve are generally thought to be the main factors that interfere with gastric motor function. However, physiological studies of reflux symptoms after esophagectomy are still lacking. Gastroesophageal reflux occurs frequently after esophagectomy, but there is no known effective method to prevent it. Therefore, in order to manage gastroesophageal reflux after esophagectomy, strict lifestyle modifications and gastric acid suppression treatment such as PPIs are needed, and further clinical studies are required.

Achalasia treated with mercury dilation (Mereury 확장으로 치유된 achalasia)

  • 이상호;홍래복
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1976.06a
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    • pp.90.1-90
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    • 1976
  • Achalasia is a disorder of the esophagus. Characterized principally by dysphagia resulting from lack of effective forward peristaltic movement of the body of the esophagus and failure of relaxation of the lower esophageal segment. It is probably caused by an extra-esophageal vagal lesion, either of the peripheral vagus nerve or of its dorsal motor nucleus. Recently the author had experienced one case of achalasia which was diagnosed by the esophagogram and esophagoscopic examination.

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Function-Preserving Surgery in Gastric Cancer

  • Bueno, Jan Andrew D.;Park, Young-Suk;Ahn, Sang-Hoon;Park, Do Joong;Kim, Hyung-Ho
    • Journal of Minimally Invasive Surgery
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    • v.21 no.4
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    • pp.141-147
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    • 2018
  • The rising incidence of early gastric cancer has enabled the development of function-preserving gastrectomy with the focus on post gastrectomy quality of life and adherence to sound oncologic principles. It is concurrent with the growing popularity of minimally invasive surgery; and both are commonly used together. The different kinds of function-preserving gastrectomy included in this review are: pylorus-preserving and proximal gastrectomy, vagus nerve preservation, sentinel node navigation, and various endoscopic & minimally-invasive techniques. In this article the indications, techniques, oncologic safety, functional benefit, and outcomes of each kind of function-preserving gastrectomy are discussed.

Non-Invasive Neuromodulation for Tinnitus

  • Langguth, Berthold
    • Korean Journal of Audiology
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    • v.24 no.3
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    • pp.113-118
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    • 2020
  • Tinnitus is a prevalent disorder that has no cure currently. Within the last two decades, neuroscientific research has facilitated a better understanding of the pathophysiological mechanisms that underlie the generation and maintenance of tinnitus, and the brain and nerves have been identified as potential targets for its treatment using non-invasive brain stimulation methods. This article reviews studies on tinnitus patients using transcranial magnetic stimulation, transcranial electrical stimulation, such as transcranial direct current stimulation, alternating current stimulation, transcranial random noise stimulation as well as transcutaneous vagus nerve stimulation and bimodal combined auditory and somatosensory stimulation. Although none of these approaches has demonstrated effects that would justify its use in routine treatment, the studies have provided important insights into tinnitus pathophysiology. Moreover bimodal stimulation, which has only been developed recently, has shown promising results in pilot trials and is a candidate for further development into a valuable treatment procedure.

Non-Invasive Neuromodulation for Tinnitus

  • Langguth, Berthold
    • Journal of Audiology & Otology
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    • v.24 no.3
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    • pp.113-118
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    • 2020
  • Tinnitus is a prevalent disorder that has no cure currently. Within the last two decades, neuroscientific research has facilitated a better understanding of the pathophysiological mechanisms that underlie the generation and maintenance of tinnitus, and the brain and nerves have been identified as potential targets for its treatment using non-invasive brain stimulation methods. This article reviews studies on tinnitus patients using transcranial magnetic stimulation, transcranial electrical stimulation, such as transcranial direct current stimulation, alternating current stimulation, transcranial random noise stimulation as well as transcutaneous vagus nerve stimulation and bimodal combined auditory and somatosensory stimulation. Although none of these approaches has demonstrated effects that would justify its use in routine treatment, the studies have provided important insights into tinnitus pathophysiology. Moreover bimodal stimulation, which has only been developed recently, has shown promising results in pilot trials and is a candidate for further development into a valuable treatment procedure.