Clinical Study On Median Nerve Electrical Stimulation Therapy In Improving The Level Of Consciousness Of Patients In Coma Caused By Head Traumas

Objective To investigate the therapeutic effect of median nerve electrical stimulation in improving the level of consciousness of patients in coma caused by head traumas and the possible mechanisms of its hastening awakening from coma. Methods 40 unconscious patients with severe head traumas were randomly assigned to the treated group (n=20) and the control group (n=20). The control group were treated routinely. Besides routine therapy the treated group were treated with median nerve electrical stimulation. As the treated group were treated with initial stimulation, SPECT brain perfusion imaging was performed before and after 30 minutes' median nerve electrical stimulation under the same condition. The changes of the regional cerebral blood flow (rCBF) of lesion spot of brain were compared and analysed with visual method and semi-quantitative method in BFCR% mathematical model. After 30 minutes' stimulation for a week, two groups have same treatments. A week after stimulation we assess the therapeutic effect of the two groups with GCS scores. Three months after injury, Glasgow Outcome Scale ,motor function and verbal function are the index of assessment for patients prognosis.Clinical Study on Median Nerve Stimulation Therapy in Improving the level of Consciousness of Patients in Coma Caused by Head Traumas AbstractAlso, the neurotransmitter such as -EP, DA, ME , E in CSF was measured by the radioimunossary before and after stimulation. Results. The treated group's rCBF of the lesion spot increased significantly after stimulation.The BFCR% of the lesion spot is 19.76 + 8.01%. A week later the treated group had improved by average of 4.81?.21 on the GCS in contrast to 1.99?.64 on the GCS of the control group, which showed that the GCS scores of the two group had significant difference (p<0.05). Three months after injury, Glasgow Outcome Scale, verbal and motor functions in the stimulation group were also statistically better than those in the control group. The 0 -EP in CSF of the treated group was more rapidly decreased than the control group(p<0.05). Conclusion The median nerve electrical stimulation can improve the level of consciousness of patients in coma caused by severe head traumas. In addition, the treatment of stimulation can reduce mortality and morbidity. The increase of rCBF of lesion spot of brain and the change of neurotransmitter in CSF can be one of mechanisms of its hastening awakening from coma.