Summary
During the past half year, we have utilized right median nerve stimulation (produced by Empi. Co. USA) to awaken consciousness of patients on 6 cases, 2 with brain trauma, one with aneurysm rupture, one with hemorrhagic stroke and two with hypoxic encephalopathy. The comatose duration ranged from 6 to 17 weeks. All patients underwent SPECT scan for cerebral perfusion evaluation and neurotransmitter quantification before and after the stimulation. The stimulation time lasted from 8 to 10 hours on daytime.
The stimulation persisted for 3 months in all patients. Four patients recovered from the consciousness within 35 days. There was no obvious clinical improvement in two patients. Brain perfusion increased in all cases through the SPECT study after stimulation. The elevation of neurotransmitter in CSF was found in 5 out of the 6 cases.
Median nerve stimulation elevates the cerebral blood flow and may influence the patient’s consciousness. Young patients (<40 years old) had better results than old patients. The stimulation could be initiated if the patient’s acute stage was over. In our series, although increase in cerebral blood flow was found in all cases, some patients did not regain consciousness.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Bouma G, Muizelaar J (1993) Evaluation of regional cerebral blood flow in acute head injury by stable xenon-enhanced computerized tomography. Acta Neurochir (Wien) [Suppl] 59: 34–40
Cooper JB, Jane JA, Cooper EB et al (1999) Right median nerve electrical stimulation to hasten awakening from coma. Brain Injury 13:261–267
Glanz M, Klawansky S, Stason W et al (1996) Functional electrostimulation in poststroke rehabilitation: a meta-analysis of the randomized controlled trials. Arch Phys Med Rehab 77: 549–553
Grady M, Jane J, Steward O (1989) Synaptic reorganization within the human central nervous system following injury. J Neurosurg 71: 534–537
Hirata Y, Ushio U (2000) A case of successful treatment by median nerve stimulation for prolonged moderate consciousness disturbance in the chronic phase following subarachnoid hemorrhage. The Society for the Treatment of Coma 9: 85–89
Hosobuchi Y (1985) Electrical stimulation of cervical spinal cord increases cerebral blood flow in humans. Appl Neurophysiol 48: 372–276
Kanno T, Kamel Y, Yokoyama T et al (1989) Effects of dorsal column stimulation (DCS) on reversibility of neuronal function — Experience of treatment for vegetative states. PACE 12: 733–738
Lawrence F, Eisenberg H, Jane J et al (1991) The outcome of severe closed head injury. Journal of Neurosurgery 75: s28–s36
Marion D, Darby J, Yonas H (1991) Acute regional cerebral blood flow changes caused by severe head injuries. J Neurosurg 74: 407–414
Meglio M, Cioni B, Visocchi F et al (1991) Spinal Cord Stimulation and Cerebral haemodynamics. Acta Neurochir (Wien) 111:43–48
Obrist WD, Langfitt TW, Jaggi JL et al (1984) Cerebral blood flow and metabolism in comatose patients with acute head injury. J Neurosurg 61: 241–253
Peri CV, Shafery ME, Cooper ED et al (2001) Pilot study of electrical stimulation on median nerve in comatose severe brain injured patients: 3-month outcome. BRAIN INJURY 15: 903–910
Scherder E, Bouma A, Steen L (1992) Influence of transcutaneous electrical nerve stimulation on memory in patients with demential of the Alzheimer’s type. Journal of Clinical and Experimental Neuropsychology 14: 951–960
Yamamoto K, Sugita S, Ishikawa K et al (1997) A case of persistent vegetative state treated with median nerve stimulation. The Society for the Treatment of Coma 5: 117–125
Yokoyama T, Kamei T, Kanno T (1996) Right median nerve stimulation for comatose patients. The Society for the Treatment of Coma 5: 117–125
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2003 Springer-Verlag Wien
About this paper
Cite this paper
Liu, JT., Wang, C.H., Chou, I.C., Sun, S.S., Koa, C.H., Cooper, E. (2003). Regaining consciousness for prolonged comatose patients with right median nerve stimulation. In: Katayama, Y. (eds) Neurosurgical Re-Engineering of the Damaged Brain and Spinal Cord. Acta Neurochirurgica Supplements, vol 87. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6081-7_3
Download citation
DOI: https://doi.org/10.1007/978-3-7091-6081-7_3
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-7223-0
Online ISBN: 978-3-7091-6081-7
eBook Packages: Springer Book Archive