RESUMO
Vagus nerve stimulation (VNS) is an acceptable and effective adjunctive therapy for pharmacoresistant epilepsy. It is generally well tolerated and the most frequent side effects reported include respiratory dysfunction. We report the case of a female patient with intractable epilepsy who was implanted with the device and achieved a significant reduction in the number of her seizures. However, she developed central-type sleep apnea documented polysomnographically. Upon reduction of her VNS parameters, the apnea resolved and her sleep study reverted to normal. To our knowledge, this is the first case reported with polysomnographic evidence of VNS induction of central-type sleep apnea.
Assuntos
Terapia por Estimulação Elétrica/efeitos adversos , Epilepsia/terapia , Apneia do Sono Tipo Central/diagnóstico , Apneia do Sono Tipo Central/etiologia , Nervo Vago , Adulto , Epilepsia/complicações , Feminino , Humanos , Polissonografia , Apneia do Sono Tipo Central/prevenção & controleRESUMO
The therapeutic potential of isovolaemic haemodilution and osmotherapy on the sequelae of middle cerebral artery occlusion has been studied in an animal model. The territory of the middle cerebral artery that failed to fill with a carbon black intravascular marker after intracranial occlusion for 30 minutes in the anaesthetised rat was reduced by 50% by isovolaemic haemodilution to a haematocrit of 30%. An intravenous infusion of 10% glycerol prevented swelling of the ischaemic hemisphere, though it did not further improve vascular perfusion. These findings support the use of isovolaemic haemodilution and osmotherapy in the acute aftermath of stroke.
