Traditional Culture Encyclopedia - Traditional customs - What are the conditions under which a vegetative person is usually awakened?
What are the conditions under which a vegetative person is usually awakened?
When we talk about "vegetative state", we always think of clips in movies and TV dramas, but in real life we seldom talk about it and pay attention to it.
Chronic disorders of consciousness generally include vegetative state (VS, vegetable state) and minimal conscious state (MCS, minimal conscious state), which are mostly caused by craniocerebral trauma, ischemia, hypoxia, and cerebrovascular disease, etc. VS refers to the unconscious activity, inability to carry out the commands, loss of cognitive function, and periodic arousal. -VS refers to unconscious activity, inability to execute commands, loss of cognitive function, periodic awakenings, purposeless eye tracking, ability to open eyes automatically or under stimulation, inability to understand and express language, maintenance of voluntary blood pressure and respiration, and basic preservation of brainstem and hypothalamus function.VS lasting for more than 1 month is called persistent vegetative state (PVS, persistent vegetable state).
How are chronic disorders of consciousness treated?Traditional treatments include medications, hyperbaric oxygen, physical therapy, sensory and environmental stimulation, noninvasive electrical stimulation (transcranial magnetic stimulation, transcranial direct current stimulation, median nerve electrical stimulation, etc.), and acupuncture, but all are ineffective. The result is that the patient has been in a vegetative state or a state of minimal consciousness can not be further improved, which will only increase the burden of the patient's family.
So, is there a better way to promote the awakening of patients?Yes, in recent years, many studies have found that high cervical spinal cord stimulation SCS may become an effective treatment for chronic disorders of consciousness. Several medical institutions at home and abroad have been carrying out this technique, and the total effective rate of awakening can be as high as 51.6%
What is spinal cord stimulation surgery (SCS)?Spinal cord stimulation (SCS) is a procedure in which stimulating electrodes are placed outside the cervical spinal cord at the C2-C4 level, and pulsed stimulation is transmitted to the cerebral cortex via the upward reticular activating system, increasing local glucose metabolism and cerebral blood flow, promoting the release of excitatory transmitters, and enhancing the impulse of consciousness and brain electrical activity, thus facilitating the patient's awakening.
Who is a candidate for spinal cord stimulation (SCS)?1. Patients with intermittent but clearly defined conscious behaviors (microconsciousness);
2. Patients with good potential for recovery of consciousness, but some patients remain stagnant for a long period of time;
3. Patients who are no longer able to improve their consciousness with traditional treatments.
Who is not a candidate for spinal cord stimulation (SCS)?1. Neurodegenerative diseases, malignant brain tumors after surgery;
2. Coma caused by or complicating the deterioration of systemic diseases, or patients with a short life expectancy;
3. The level of consciousness has reached a diagnosis of being out of the microconsciousness, i.e., patients who can use objects or communicate effectively with the outside world;
4. There is progressive improvement or deterioration in consciousness over a period of weeks.
What else can spinal cord stimulation (SCS) treat in addition to promoting awakening in vegetative patients?SCS surgery can be used to treat a number of other chronic pain conditions in addition to vegetative awakening
diabetic foot pain;
peripheral ischemic pain;
postherpetic neuralgia;
failed spinal surgery syndrome (FBSS);
nerve root pain syndrome/neurogenic disorders;
phantom limb pain/stump pain...
In addition to appealing chronic pain:
Arachnoiditis/lumbar adhesive arachnoiditis;
Dural fibrosis;
peripheral nerve burning pain;
Reflex sympathetic dystrophy (RSD) or neuralgia;
chronic refractory angina pectoris...
These chronic pains are often poorly treated with medications, using high doses of medications, high side effects, and causing serious damage to the body; therefore, when medications are not effective in relieving pain, SCS surgery is feasible to relieve pain.
Mechanism of action of spinal cord electrical stimulation (SCS) surgery for chronic painSCS is a treatment that controls pain and relieves symptoms through weak electrical stimulation of spinal cord nerves. It generates weak electrical stimulation through a neurostimulator implanted subcutaneously in the abdomen, which is conducted to the dorsal columns of the spinal cord via electrodes placed in the epidural space to affect areas innervated by peripheral nerves in different segments. Studies have shown that spinal cord electrical stimulation is capable of directing microcurrents to the specific nerves needed to activate muscles, and that sustained stimulation induces the restoration of nerve function and inhibits the transmission of pain signals to the brain.
SCS broadly inhibits hyperexcitability of neurons in the wide power range of the dorsal horn of the spinal cord, eases the release of inhibitory neurotransmitters, such as GABA, and inhibits the release of excitatory neurotransmitters, such as glutamate and aspartate.
Generally when SCS surgery is used to treat chronic pain, it needs to be divided into two steps, the first step is to implant the electrodes first, the external stimulator, and observe the patient's pain relief by adjusting the parameters, as well as the side effects of the parameter adjustment. After a few days of observation, if the pain relief effect is good, the pulse generator can be implanted in the body in the second phase. If the pain relief effect is not good, the electrodes can be removed and the treatment program can be changed, such as changing to morphine pump implantation.
The patient has been unable to wake up, the long-term treatment expenditure and the burden of complicated care, which brings both economic and psychological pressure on the family. For the moment, waking up vegetative patients is still a worldwide medical problem. In order to better help this patient group, our hospital has set up the Wake-up Center for Consciousness Disorders, which adopts the advanced way of waking up - Spinal Cord Electrical Stimulation Surgery (SCS) treatment in the hope that more patients with consciousness disorders will benefit from it!
Donglei Brain Hospital Wake-Up Center for Disorders of ConsciousnessMultidisciplinary team of experts
The hospital's Wake-Up Center for Disorders of Consciousness consists of a multidisciplinary team of neurosurgery, neurology, intensive care medicine, rehabilitation, radiology, and other disciplines, which provides patients with professional and personalized diagnostic and treatment services.
Multi-method, comprehensive and fine assessment system to guide the treatment
In terms of the assessment of the state of consciousness, in addition to the CRS-R scale, the team also adopts fMRI, DTI, CTP, EEG, and Brain-Computer Interface to assess the whole process of the patient, so as to clarify the changes in the state of consciousness of the patient, and thus provide reference and guidance to the whole process of our treatment.
Early intervention, standardized wake-up treatment process
The whole treatment process of comatose patients includes critical care, management of complications, assessment of the state of consciousness, medication to promote wake-up, rehabilitation to promote wake-up, and surgical wake-up. The team will start the treatment of comatose patients from the early stage around wakefulness promotion, and form a set of standardized wakefulness promotion process, so as to improve the patient's wakefulness treatment effect.
*Note: The above drugs are only for clinical diagnosis of patients, the doctor prescribed treatment, patients should not buy their own diagnosis of drug treatment.
Because of the limitations of the text and content, can not meet the needs of each person, to answer all questions, only a basic reference material. If you would like a targeted solution, please contact one of our medical professionals who will be able to provide you with specialized guidance based on your situation.
Whenever you need help, don't forget: don't be afraid, we are by your side and ready to help.
Wishing you good health!
- Previous article:Four ancient towns in Mianyang
- Next article:Excerpts from good words and sentences of Mid-Autumn Festival
- Related articles
- What are the development processes of grain crop production in China in the past 55 years?
- A Brief History of Stanford University 1- The Birth of the University
- Why are five of the eight planets named after "Jin Mu Fire, Water and Earth", which happens to be the five elements of China?
- Life Values Speech
- What are the types of double-entry bookkeeping? What is the account structure?
- How can I catch big fish in winter?
- What is the efficacy of Panax ginseng Panax quinquefolius efficacy and function
- What brand is Valentino?
- How did paper cutting, a traditional Chinese cultural item, come about? Must be detailed
- Where can I find delicious food in Wendeng?