Sensitive sensory stimulation for the arousal treatment of a persistent vegetative state following traumatic brain injury: a care-compliant case report

Huiwen Mao, Yan Li
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Abstract

Effective treatments for patients in a persistent vegetative state due to traumatic brain injury (TBI) are currently unavailable. The purpose of this study was to investigate the therapeutic use of sensitive sensory stimulation for patients in persistent vegetative state following TBI. This case report discussed a 36-year-old male patient who experienced TBI 75 days prior to admission. Upon hospital admission, the patient was unconscious, could automatically open his eyes, but could not avoid light, trace motions, or execute commands. He was placed on a nasal feeding diet, exhibited urinary and fecal incontinence and developed postoperative urinary retention and a pulmonary infection. He showed no mobility of the upper and lower extremities with hypomyotonia. Medications for nerve repair, regaining consciousness, preventing seizure, resolving phlegm, and protecting the stomach were administered. The activity of the extremities was improved by exercise therapies and low or medium-frequency electric stimulation, bladder and bowel function was improved by acupuncture and abdominal massage, and consciousness recovery was promoted by acupuncture and hyperbaric oxygen therapy. Five months following admission, the patient regained consciousness with improved bladder and bowel function. Electroencephalogram indicated that brain function had significantly improved. Auditory evoked potentials and somatosensory evoked potentials suggested that sensation conduction pathways had improved significantly. Sensitive sensory stimulation in combination with routine rehabilitation treatment can effectively cause the regain of consciousness in patients with persistent vegetative state following TBI and improve activities of daily living and the function of the sensation conduction pathways..
敏感感觉刺激对创伤性脑损伤后持续性植物人状态的唤醒治疗:一个符合护理要求的病例报告
由于创伤性脑损伤(TBI)导致持续性植物状态的患者目前尚无有效的治疗方法。本研究的目的是探讨敏感感觉刺激对创伤性脑损伤后持续性植物状态患者的治疗作用。本病例报告讨论了一位36岁男性患者在入院前75天经历了TBI。入院时,病人失去知觉,能自动睁开眼睛,但不能躲避光线,不能追踪运动,也不能执行命令。患者采用鼻饲饮食,出现尿失禁和大便失禁,术后出现尿潴留和肺部感染。他表现出上肢和下肢不活动,并伴有肌张力低下。给予神经修复、恢复意识、预防癫痫发作、化痰、护胃等药物。运动疗法和中低频电刺激可改善四肢活动,针灸和腹部按摩可改善膀胱和肠道功能,针灸和高压氧治疗可促进意识恢复。入院5个月后,患者恢复意识,膀胱和肠道功能改善。脑电图显示脑功能明显改善。听觉诱发电位和体感诱发电位提示感觉传导通路明显改善。敏感感觉刺激结合常规康复治疗,可有效使脑外伤后持续性植物状态患者恢复意识,改善日常生活活动能力和感觉传导通路功能。
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