title: Symptomatic treatment of unresponsive wakefulness syndrome with transcranially focused extracorporeal shock waves.
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)?
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Outpatient Department for Manual Medicine - Movement Disorder Center, Rheintalklinik, Bad Krozingen, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Lohse-Busch
authors.affiliation: Outpatient Department for Manual Medicine - Movement Disorder Center, Rheintalklinik, Bad Krozingen, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Reime
authors.affiliation: Outpatient Department for Manual Medicine - Movement Disorder Center, Rheintalklinik, Bad Krozingen, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Falland
mesh_terms: D000328:Adult; D001143:Arousal; D001288:Attention; D001930:Brain Injuries / Q000150:complications; D003128:Coma / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D015600:Glasgow Coma Scale; D006556:Heroin Dependence / Q000150:complications; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function; D013577:Syndrome; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D014851:Wakefulness; D055815:Young Adult
keywords: Unresponsive wakefulness syndrome; apallic; extracorporeal shock wave therapy