Response

Abstract

We appreciate the interest of Drs. Papathanasiou and Papacostas in our article on obstructive sleep apnea in children with vagal nerve stimulators [ [1] Hsieh T. Chen M. McAfee A. Kifle Y. Sleep-related breathing disorder in children with vagal nerve stimulators. Pediatr Neurol. 2008; 38: 99-103 Abstract Full Text Full Text PDF PubMed Scopus (54) Google Scholar ]. Their case of central sleep apnea with a vagal nerve stimulator is also interesting. Their report highlights the variability of presentation in this clinically significant disorder. The explanation they propose appears plausible, but the precise mechanism of action of vagal nerve stimulation on sleep-related breathing is uncertain. Our study and their case report further emphasize that severe and clinically significant disturbances in sleep-related breathing may occur with vagal nerve stimulators, and that it may be prudent to monitor these patients routinely for adverse effects. Sleep-Related Breathing Disorders in Children With Vagal Nerve StimulatorsPediatric NeurologyVol. 39Issue 2PreviewWe read with interest the article by Hsieh et al. [1] regarding findings of obstructive sleep apnea in children with vagal nerve simulators and who manifested severe epilepsy. We also reported on sleep-related breathing disorder in a 19-year-old female with intractable epilepsy, but in our case, only central sleep apnea was recorded [2]. The question that arises, therefore, is, “Why the difference?” We noted that the output current used in our case (3.5 mA) was much higher than that used in the study of Hsieh et al. Full-Text PDF