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Table of Contents
Vol. 88, No. 4, 2010
Issue release date: July 2010
Section title: Review
Free Access
Stereotact Funct Neurosurg 2010;88:199–207

Vegetative State and Minimally Conscious State: A Review of the Therapeutic Interventions

Georgiopoulos M.a · Katsakiori P.a · Kefalopoulou Z.a · Ellul J.b · Chroni E.b · Constantoyannis C.a
aFunctional Neurosurgery Unit, Department of Neurosurgery, and bDepartment of Neurology, Medical School of Patras, Patras, Greece
email Corresponding Author

Constantine Constantoyannis, Assistant Professor

Functional Neurosurgery Unit, Department of Neurosurgery

Medical School of Patras

GR–26500 Patras (Greece)

Tel. +30 26 1099 9495, Fax +30 26 1099 2997, E-Mail cconst@med.upatras.gr

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Background/Aims: The purpose of the present article is a systematic review of the proposed medical or surgical treatments in patients in chronic vegetative state (VS) or minimally conscious state (MCS), as well as of their mechanisms of action and limitations. Methods: For this review, we have agreed to include patients in VS or MCS having persisted for over 6 months in posttraumatic cases, and over 3 months in nontraumatic cases, before the time of intervention. Searches were independently conducted by 2 investigators between May 2009 and September 2009 in the following databases: Medline, Web of Science and the Cochrane Library. The electronic search was complemented by cross-checking the references of all relevant articles. Overall, 16 papers were eligible for this systematic review. Results: According to the 16 eligible studies, medical management by dopaminergic agents (levodopa, amantadine), zolpidem and median nerve stimulation, or surgical management by deep brain stimulation, extradural cortical stimulation, spinal cord stimulation and intrathecal baclofen have shown to improve the level of consciousness in certain cases. Conclusion: The treatments proposed for disorders of consciousness have not yet gained the level of ‘evidence-based treatments’; moreover, the studies to date have led to inconclusiveness. The published therapeutic responses must be substantiated by further clinical studies of sound methodology.

© 2010 S. Karger AG, Basel

Article / Publication Details

First-Page Preview
Abstract of Review

Received: December 01, 2009
Accepted: March 14, 2010
Published online: May 12, 2010
Issue release date: July 2010

Number of Print Pages: 9
Number of Figures: 0
Number of Tables: 2

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: http://www.karger.com/SFN

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