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Symptomatic treatment of unresponsive wakefulness syndrome with transcranially focused extracorporeal shock waves

Article type: Research Article

Authors: Lohse-Busch, H.; * | Reime, U. | Falland, R.

Affiliations: Outpatient Department for Manual Medicine – Movement Disorder Center, Rheintalklinik, Bad Krozingen, Germany

Correspondence: [*] Address for correspondence: H. Lohse-Busch, MD, Outpatient Department for Manual Medicine – Movement Disorder Center, Rheintalklinik, Im Rheintal 5, D-79189 Bad Krozingen, Germany. Tel.: +49 7633 408 836; Fax: +49 7633 408 842; E-mail: lohse-busch@amm-rheintalklinik.de

Keywords: Unresponsive wakefulness syndrome, apallic, extracorporeal shock wave therapy

DOI: 10.3233/NRE-141115

Journal: NeuroRehabilitation, vol. 35, no. 2, pp. 235-244, 2014

Published: 7 October 2014
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Abstract

Objective:

Can stimulation of nerve growth factors by focused transcranial extracorporeal shock wave therapy (TESWT) be made effective for persons within unresponsive wakefulness syndrome (apallic syndrome)?

Design:

Between eight and 18 years after the brain lesion, five patients with unresponsive wakefulness syndrome of differing severity received TESWT with the device Duolith (Storz Medical) during four-week physicomedical complex therapies. In the previous years they had been treated with the same complex therapies without TESWT. The vigilance did not change.

Results:

After two-four years and an average of 5.2 treatment series, the patients' abilities improved by 135.9% on the German Coma Remission Scale (KRS) and by 43.6% on the Glasgow Coma Scale. In the motor area of the KRS, the patients improved by 64.3%. Three PEG feeding tubes could be removed, nonverbal communication initiated four times.

Conclusion:

In this longitudinal observation study, focused TESWT stimulated vigilance in patients with unresponsive wakefulness syndrome. The precise neurophysiological effects remain to be verified by a study of the clinical results.

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