Abstract
Introduction:Vagus nerve stimulation (VNS) is an adjunct therapy to anti-epileptics in patients where combination drug therapy alone has failed. The VNS device resembles an implantable defibrillator, and can be found underneath the clavicle on either side of the chest. By using a strong ring magnet, the device can be manipulated to seize function or operate on higher intensities, depending on how it is applied. The use of vagal stimulation is increasingly common and VNS is being explored for a range of other medical complaints.Case:This case study discusses the encounter between a paramedic and a woman presenting with a choking sensation, isolated uvular deviation and stable cardiorespiratory functions. Following a short period of observation without adverse events, she was discharged on scene and advised to see her specialist epilepsy nurse.Conclusion:Side effects of VNS increase with intensity of stimulation and can manifest throughout any branch of the vagus nerve. Its therapeutic mechanism of action is yet to be fully understood. The symptoms of over-stimulation are often frightening but benign, and although life-threatening events are rare, they require rapid recognition and immediate intervention.
Highlights
ConclusionSide effects of Vagus nerve stimulation (VNS) increase with intensity of stimulation and can manifest throughout any branch of the vagus nerve
Vagus nerve stimulation (VNS) is an adjunct therapy to anti-epileptics in patients where combination drug therapy alone has failed
Vagus nerve stimulation (VNS) is a palliative adjunct therapy used in some of the 280,000 to 320,000 people suffering from epilepsy in the United Kingdom (UK) (Booth & Thompson, 2010; Scottish Intercollegiate Guidelines Network (SIGN), 2015)
Summary
Side effects of VNS increase with intensity of stimulation and can manifest throughout any branch of the vagus nerve. The symptoms of over-stimulation are often frightening but benign, and life-threatening events are rare, they require rapid recognition and immediate intervention
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