Abstract
Twenty cases of a persistent vegetative state (PVS) caused by various kinds of brain damage were neurologically and electrophysiologically evaluated at 3 months after persistence of the PVS, and were treated by deep brain stimulation (DBS) therapy. The stimulation sites were the mesencephalic reticular formation (2 cases) and CM-pf complex (18 cases). Seven of the patients emerged from the PVS, and became able to obey verbal commands. However, they remained in a bedridden state. These 7 cases revealed a desynchronization or slight desynchronization pattern on continuous EEG frequency analysis. The Vth wave of ABR and N20 of SEP could be recorded even with a prolonged latency, and the pain-related P250 was recorded with an amplitude of over 7 µV. We conclude that chronic DBS therapy may be useful for allowing the patient to emerge from a PVS, if the candidates are selected according to the neurophysiological criteria. In view of the severely disabled state of the patients who emerged from the PVS, a special rehabilitation program which includes neurostimulation therapy may be necessary for treatment of the PVS.
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References
Dempsey EWA, Morison RS (1942) A study of thalamo cortical relations. Am J Physiol 135: 291–292
Jasper HH, Naquet R, King LE (1955) Thalamocortical recruiting responses in sensory receiving areas in the cat. Electroencephalogr Clin Neurophysiol 7: 99–114
Jennett B, Plum F (1972) Persistent vegetative state after brain damage. Lancet 1: 734–737
Katayama Y, Tsubokawa T, Harano S, Tsukiyama T (1985) Dissociation of subjective pain report and pain-related late positive component of cerebral evoked potentials in subjects with brain lesions. Brain Res Bull 14: 423–426
Katayama Y, Tsubokawa T, Yamamoto T, Hirayama T, Miya zaki S, Koyoma S (1991) Characterization and modification of brain activity with deep brain stimulation in a persistent vegetative state. Pacing Clin Electrophysiol 14: 116–121
Luthi A, McCormick DA (1998) H-Current: Properties of a neuronal and network pacemaker. Neuron 21: 9–12
The Multi-Society Task Force on PVS (1994) Medical aspects of the persistent vegetative state (First of two parts). N Engl J Med 330: 1499–1508
The Multi-Society Task Force on PVS (1994) Medical aspects of the persistent vegetative state (Second of two parts). N Engl J Med 330: 1572–1579
Tsubokawa T, Yamamoto Y, Katayama Y, Hirayama T, Maejima S, Moriya T (1990) Deep brain stimulation in a persistent vegetative state: Follow-up results and criteria for selection of candidates. Brain Injury 4: 315–327
Tsubokawa T, Yamamoto T, Katayama Y (1990) Prediction of the outcome of prolonged coma caused by brain damage. Brain Injury 4: 329–337
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© 2002 Springer-Verlag Wien
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Yamamoto, T., Katayama, Y., Oshima, H., Fukaya, C., Kawamata, T., Tsubokawa, T. (2002). Deep Brain Stimulation Therapy for a Persistent Vegetative State. In: von Wild, K.R.H. (eds) Functional Rehabilitation in Neurosurgery and Neurotraumatology. Acta Neurochirurgica Supplements, vol 79. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6105-0_18
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DOI: https://doi.org/10.1007/978-3-7091-6105-0_18
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-7283-4
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