Effect of Treatment of Obstructive Sleep Apnea by Uvulopalatoplasty on Seizure Outcomes: A Case Report
Abstract
It is estimated that one-third of the people with refractory epilepsy suffer from obstructive sleep apnea (OSA). In a patient presenting with OSA symptoms and epilepsy, removing a portion of the soft palate (uvulopalatoplasty) can be considered the treatment of choice for eliminating the OSA and decreasing the seizures.Here, we report the results of our surgical approach by which the patient’s problems completely resolved, and we observed no symptoms of OSA or epilepsy after the surgery. After 10 years of follow-up, the patient is seizure-free and does not need any antiepileptic drugs.
- Roberts HW. The effect of electrical dental equipment on a vagus nerve stimulator’s function. J Am Dent Assoc. 2002 Dec;133(12):1657-64.
- Rezaee Kh, Azizi E, Haddadnia J. Optimized Seizure Detection Algorithm: A Fast Approach for Onset of Epileptic in EEG Signals Using GT Discriminant Analysis and K-NN Classifier. J Biomed Phys Eng. 2016 Jun;6(2): 81-94.
- Brodie MJ, French JA. Management of epilepsy in adolescents and adults. Lancet. 2000 Jul 22;356(9226):323-9.
- Malow BA, Levy K, Maturen K, Bowes R. Obstructive sleep apnea is common in medically refractory epilepsy patients. Neurology. 2000 Oct 10;55(7):1002-7.
- Zanzmera P, Shukla G, Gupta A, Goyal V, Srivastava A, Garg A, et al. Effect of successful epilepsy surgery on subjective and objective sleep parameters--a prospective study. Sleep Med. 2013 Apr;14(4): 333-8.
- Li H, Li L, Shao Y, Gong H, Zhang W, Zeng X, et al. Abnormal Intrinsic Functional Hubs in Severe Male Obstructive Sleep Apnea: Evidence from a Voxel-Wise Degree Centrality Analysis. PLoS One. 2016 Oct 10;11(10):e0164031.
- Šujanská A, Ďurdík P, Rabasco J, Vitelli O, Pietropaoli N, Villa MP. Surgical and non-surgical therapy of obstructive sleep apnea syndrome in children. Acta Medica (Hradec Kralove). 2014;57(4):135-41.
- Conway WA, Victor LD, Magilligan DJ Jr, Fujita S, Zorick FJ, Roth T. Adverse effects of tracheostomy for sleep apnea. JAMA. 1981 Jul 24-31;246(4):347-50.
- Heidsieck DS, de Ruiter MH, de Lange J. Management of obstructive sleep apnea in edentulous patients: an overview of the literature. Sleep Breath. 2016 Mar;20(1):395-404.
- Verse T, Hörmann K. The Surgical Treatment of Sleep-Related Upper Airway Obstruction. Dtsch Arztebl Int. 2011 Apr;108(13):216-21.
- Hendler BH, Costello BJ, Silverstein K, Yen D, Goldberg A. A protocol for uvulopalatopharyngoplasty, mortised genioplasty, and maxillomandibular advancement in patients with obstructive sleep apnea: an analysis of 40 cases. J Oral Maxillofac Surg. 2001 Aug;59(8):892-7.
- Cohen SR, Lefaivre JF, Burstein FD, Simms C, Kattos AV, Scott PH, et al. Surgical Treatment of Obstructive Sleep Apnea in Neurologically Compromised Patients. Plast Reconstr Surg. 1997 Mar;99(3):638-46.
- Sullivan CE, Issa FG, Berthon-Jones M, Eves L. Reversal of obstructive sleep apnea by continuous positive airway pressure through the nares. Lancet. 1981 Apr 18;1(8225):862-5.
- Victor LD. Obstructive Sleep Apnea. Am Fam Physician. 1999 Nov 15;60(8):2279-86.
- Wheless JW, Baumgartner J, Ghanbari C. Vagus nerve stimulation and the ketogenic diet. Neurol Clin. 2001 May;19(2):371-407.
- Kennedy PA, Schallert G. Practical issues and concepts in vagus nerve stimulation: a nursing review. J Neurosci Nurs. 2001 Apr;33(2):105-12.
- Handforth A, DeGiorgio CM, Schacther SC, Uthman BM, Naritoku DK, Tecoma ES, et al. Vagus nerve stimulation therapy for partial-onset seizures: a randomized active-control trial. Neurology. 1998 Jul;51(1):48-55.
- Chang EF, Englot DJ, Vadera S. Minimally invasive surgical approaches for temporal lobe epilepsy. Epilepsy Behav. 2015 Jun;47:24-33.
- Amar AP, Levy ML, McComb JG, Apuzzo ML. Vagus nerve stimulation for control of intractable seizures in childhood. Pediatr Neurosurg. 2001 Apr;34(4):218-23.
- Seo SH, Lee JG, Yu SB, Kim DS, Ryu SJ, Kim KH. Predictors of difficult intubation defined by the intubation difficulty scale (IDS): predictive value of 7 airway assessment factors. Korean J Anesthesiol. 2012 Dec;63(6):491-7.
- Khan A, Ramar K, Maddirala S, Friedman O, Pallanch JF, Olson EJ. Uvulopalatopharyngoplasty in the Management of Obstructive Sleep Apnea: The Mayo Clinic Experience. Mayo Clin Proc. 2009 Sep;84(9):795-800.
- Devinsky O, Ehrenberg B, Barthlen GM, Abramson HS, Luciano D. Epilepsy and sleep apnea syndrome. Neurology. 1994 Nov;44(11):2060-4.
- Dominici M, Pompeu-Filho F, da Mota Gomes M. Probable causal link between epilepsy and sleep apnea: case report. Arq Neuro Psiquiatr. 2007 Mar;65(1):164-6.
- Kaminska M, Kimoff RJ, Benedetti A, Robinson A, Bar-Or A, Lapierre Y, et al. Obstructive sleep apnea is associated with fatigue in multiple sclerosis. Mult Scler. 2012 Aug;18(8):1159-69.
- Marrie RA, Reider N, Cohen J, Trojano M, Sorensen PS, Cutter G, et al. A systematic review of the incidence and prevalence of sleep disorders and seizure disorders in multiple sclerosis. Mult Scler. 2015 Mar;21(3):342-9.
- Riley RW, Powell NB, Guilleminault C. Obstructive sleep apnea syndrome: a review of 306 consecutively treated surgical patients. Otolaryngol Head Neck Surg. 1993 Feb;108(2):117-25.
- Rosenzweig I, Glasser M, Crum WR, Kempton MJ, Milosevic M, McMillan A, et al. Changes in Neurocognitive Architecture in Patients with Obstructive Sleep Apnea Treated with Continuous Positive Airway Pressure. EBioMedicine. 2016 May;7:221-229.
- McMillan A, Bratton DJ, Faria R, Laskawiec-Szkonter M, Griffin S, Davies RJ, et al. A multicenter randomized controlled trial and economic evaluation of continuous positive airway pressure for the treatment of obstructive sleep apnea syndrome in older people: PREDICT. Health Technol Assess. 2015 Jun;19(40):1-188.
- Malow BA, Foldvary-Schaefer N, Vaughn BV, Selwa LM, Chervin RD, Weatherwax KJ, et al. Treating obstructive sleep apnea in adults with epilepsy: a randomized pilot trial. Neurology. 2008 Aug 19;71(8): 572-7.
- Nath Zallek S, Chervin RD. Improvement in cluster headache after treatment for obstructive sleep apnea. Sleep Med. 2000 Apr 1;1(2):135
Files | ||
Issue | Vol 14, No 6 (2017) | |
Section | Case Report | |
Keywords | ||
Sleep Apnea Epilepsy Seizure |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |