Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Jan 27:11:81-83.
doi: 10.1016/j.ebcr.2019.01.004. eCollection 2019.

Forced normalization after turning off vagus nerve stimulation in Lennox-Gastaut syndrome

Sydney Lee  1 , Alyssa Denton  1 , Lady Diana Ladino  2 , Karen Waterhouse  3 , Aleksander Vitali  4 , Jose Francisco Tellez-Zenteno  3
Affiliations
Case Reports

Forced normalization after turning off vagus nerve stimulation in Lennox-Gastaut syndrome

Sydney Lee et al. Epilepsy Behav Case Rep. .

Abstract

Forced normalization is the development of psychiatric symptoms in a patient experiencing remission of seizures. We present a case of Lennox Gastaut syndrome in which forced normalization developed after vagus nerve stimulation was stopped. The patient had drug resistant epilepsy and failed anti-seizure drugs, vagus nerve stimulation, and a partial callosotomy. The patient had multiple types of seizures including drop attacks, absences, and tonic-clonic seizures. He tried vagus nerve stimulation for two years without success. Forced normalization developed after the vagus nerve stimulator was turned off. This is the first case to our knowledge to describe forced normalization after turning off the vagus nerve stimulator.

Keywords: ACTH, adrenocorticotropic hormone; ASD, anti-seizure drug; EEG, electroencephalography; FN, forced normalization; Forced normalization; LGS, Lennox Gastaut syndrome; Lennox Gastaut syndrome; VNS, vagus nerve stimulation; Vagus nerve stimulation.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
This page shows the presence of bursts of generalized spike–wave in an awake sample (bipolar montage). The sample was taken during a week of frequent seizures.
Fig. 2
Fig. 2
Shows a wakefulness sample during a period of psychosis (bipolar montage).
See this image and copyright information in PMC

References

    1. Landolt H. Some clinical EEG correlations in epileptic psychoses (twilight states) Electroencephalogr Clin Neurophysiol. 1953;5:121.
    1. Wolf P. Acute behavioural symptomatology at disappearance of epileptiform EEG abnormality: paradoxical or forced normalization. In: Smith D., Trieman D., Trimble M.R., editors. Neurobehavioural problems in epilepsy. Raven; New York City, NY: 1991. pp. 127–142. - PubMed
    1. Loganathan M.A., Enja M., Lippmann S. Forced normalization: epilepsy and psychosis interaction. Innov Clin Neurosci. 2015;12(5–6):38–41. - PMC - PubMed
    1. Krishnamoorthy E.S., Trimble M.R. Forced normalization: clinical and therapeutic relevance. Epilepsia. 1999;40(10):S57–S64. - PubMed
    1. Blumer D., Davies K., Alexander A., Morgan S. Major psychiatric disorders subsequent to treating epilepsy by vagus nerve stimulation. Epilepsy Behav. 2001;2:466–472. - PubMed

Publication types

LinkOut - more resources