Electro-oculographic study of caloric vestibular reactions in patients with severe head injuries.
In this study electro-oculographic recordings were made after caloric vestibular stimulation (C.O.G.) in 42 patients with severe head-injuries. The curves with eyes open and the changes when eyes were closed were evaluated and scored. A correlation was found between the C.O.G. and the state of consciousness but only the degree of improvement of the C.O.G. showed a good correlation with the clinical improvement. The presence of a paradoxical response in patients with a prolonged coma was found to predict possibilities of further improvement. It was proposed that in the patients with a paradoxical response a rather diffuse biochemical dysfunction of the brain-stem was present, which could be influenced by treatment. In the second part of this study the results of the trials with a treatment with L-Dopa and physostigmine are given. It was found that patients in a vegetative state or in a state of prolonged coma could be stimulated with the therapy only when the paradoxical response had been present. L-Dopa and physostigmine respectively improved the motor pattern and the contact activities.
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000175:diagnosis* / Q000188:drug therapy; D002150:Caloric Tests; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000175:diagnosis / Q000188:drug therapy; D004585:Electrooculography; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008875:Middle Aged; D010830:Physostigmine / Q000627:therapeutic use; D011379:Prognosis; D013997:Time Factors; D014474:Unconsciousness / Q000175:diagnosis / Q000188:drug therapy; D014724:Vestibular Function Tests
D007980:Levodopa; D010830:Physostigmine