Purpose. The goal of this work was documentation of incidence, phenomenology, pathogenesis, and treatment of @entity146 occurring subsequent to treating @entity302 by vagus nerve stimulation (VNS).Methods. In a series of 81 @entity1 treated by VNS, all @entity1 who developed major @entity146 complications underwent systematic @entity146 evaluation and treatment with psychotropic medication; VNS was modified if necessary.Results. After the @entity410 frequency was reduced by at least 75%, 7 of 81 @entity1 (9%) developed major @entity146 : Six became severely @entity55840 (5 with catastrophic rage and 4 with @entity716 ), and one became @entity716 . All 7 @entity1 had experienced @entity74 and 2 had experienced @entity716 prior to the VNS treatment. Five @entity1 had frequent daily @entity410 prior to treatment. Remission or satisfactory improvement was achieved with psychotropic medication in 6 @entity1 , aided by decreasing or interrupting VNS in two @entity1 . One @entity1 was noncompliant and suffered a fatal outcome.Conclusion. Severe @entity74 associated with catastrophic rage and @entity716 may develop on suppressing @entity410 by VNS in @entity1 with previous @entity302 -related @entity146 . @entity1 with multiple daily @entity410 may be more vulnerable to this occurrence. The phenomenon corresponds to the common finding of interictal @entity55840 and @entity716 emerging when inhibitory mechanisms predominate (alternative @entity146 in the absence of @entity410 , or forced normalization of the EEG). The @entity55840 symptom of catastrophic rage appears to occur more often on @entity410 suppression by VNS than by antiepileptic drugs. Psychiatric intervention, primarily with antidepressant medication, must be available to secure a good outcome; decrease of VNS may occasionally be required.

Major @entity146 Subsequent to Treating XXXX by Vagus Nerve Stimulation.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity410 :: ('MESH:D012640', 'Disease') :: ['seizure', 'seizures'] @entity146 :: ('MESH:D001523', 'Disease') :: ['psychiatric', 'psychiatric disorders'] @entity55840 :: ('MESH:C565864', 'Disease') :: ['dysphoric'] @entity302 :: ('MESH:D004827', 'Disease') :: ['epilepsy'] @entity716 :: ('MESH:D011605', 'Disease') :: ['psychotic', 'psychotic episodes', 'psychotic symptoms'] @entity74 :: ('MESH:D030342', 'Disease') :: ['interictal dysphoric disorders', 'dysphoric disorders']
@entity302 :: (MESH:D004827,Disease) :: ['Epilepsy']
