[Effects of neurostimulation on the reversibility of neuronal function: experience of treatment for vegetative...

Developments in the diagnostic procedures, microsurgical techniques, intensive care, and the social rescue system have lowered the mortality in cerebrovascular diseases, head injuries and other emergencies of neurology and neurosurgery. However, this decreased mortality has given rise to a new social and medical problem i.e. vegetative status, which is an increase in the number of people who live on with mild or severe residual neurological deficits. During the last two years, we have used dorsal column stimulation (DCS) for improving spasticity of hemiplegics. While doing so, we incidentally found an improvement in the EEG in some of the cases. This led us to use dorsal column stimulation in cases of vegetative status. In this paper, we describe methodology and our experience with ten cases of vegetative status. All cases satisfied the definition of "vegetative status" and had received medical treatment for more than 3 months prior to DCS without showing any clinical improvement. A neurostimulator made by "Medtronic Neuro" was used. The neurostimulator was implanted in epidural space, in midline, at C-2 level under general anaesthesia. Video recording of clinical conditions, EEG, rCBF and catecholamine metabolism in CSF at regular intervals were monitored to see the efficacy of this treatment.

1) There was an improvement in the EEG in nine cases out of ten cases after neurostimulation. This was in the form of appearance of more wide spread alpha-waves, and was noticed between 3 to 14 days after starting the neurostimulation. 2) Four of these cases showed good clinical improvement. In the other four cases there was slight clinical improvement.(ABSTRACT TRUNCATED AT 250 WORDS)