Trigeminal Neuralgia Associated with Vagus Nerve Stimulation: A Case Presentation and Literature Review

Vagus nerve stimulation (VNS) is an effective therapeutic option that is widely used worldwide in drug-resistant epilepsy cases. Because it is a surgical procedure, some complications may develop with VNS implantation. Although VNS-related pain symptoms have been reported, VNS-related trigeminal neuralgia is an unexpected and rather rare side effect. This report presents a case of trigeminal pain as an adverse effect of VNS. A patient with drug-resistant epilepsy undergoing VNS treatment developed pain synchronously with stimulation in his left upper and lower jaw and teeth. Pain occurred on the day of stimulation’s current intensity (SCI) increase. The sudden disappearance of pain with decreasing SCI suggested that trigeminal pain was related to VNS. Because it is a rare side effect, trigeminal pain may not be regarded as a VNS-related side effect and may lead to unnecessary examinations. Being a rapidly reversible side effect, recognizing it and reducing SCI is crucial. VNS stimulation paradigms on nociception are still largely unknown, and it will be an important step to elucidate the important impact of VNS in pain modulation

A Comparision of Video EEG Monitoring and Routine EEG for Diagnosis of Epilepsy

Objective:The aim of this study was to investigate the diagnostic utility of routine electroencephalogram and video electroencephalogram monitoring.Methods:We performed a retrospective analysis on patients admitted to our video electroencephalogram monitoring unit. The yield of routiene electroencephalogram and video electroencephalogram monitoring was compared and assessed with the detection of epileptiform discharges.Results:Out of 191 patients, the epileptiform discharges found in routiene electroencephalogram and video electroencephalogram monitoring were 39 (21%) and 99 (52%), respectively. The yield of epileptiform discharges differed significantly between video electroencephalogram monitoring and routiene electroencephalogram (P < .001). While the epileptiform discharges detection rate (95% CI) was 0.29 (0.25-0.46) for routiene electroencephalogram, it was 0.93 (0.86-0.97) for video electroencephalogram monitoring.Conclusion:Compared to routiene electroencephalogram, video electroencephalogram monitoring is superior in detecting epileptiform discharges