Subvert your cognition! Brain damage makes them vegetative? They can't speak but can cry? In order to wake them up...

The short drama that has been flooding the screen recently is really too addictive

Who else hasn't seen it?

Classic lines from the housekeeper:

I haven't seen the young master smile like this for a long time.

Classic plot of the domineering president:

After being in a coma for many years, he woke up at the call of the heroine.

Can run and jump, can carry the heroine with one hand

Wait a minute

Do you have these understandings about vegetative state?

"A vegetative person is just sleeping, wake him up."

"His eyes are open, but he's still a vegetable?"

"The treatment of a vegetative patient is to talk to him next to him"

…

Stop, stop.

The results may subvert your cognition

"Vegetative state" is also known as "chronic impaired consciousness " in medicine. It refers to a state of loss of consciousness for more than 28 days due to severe brain damage due to various causes.

Image source: Photo Network

In our country, the number of patients in long-term coma is increasing at a rate of 100,000 to 150,000 per year, bringing a huge burden to both families and society.

Their body functions are sound , they can breathe and absorb nutrients independently, and children can even grow up. The body can also produce some instinctive reflexes to external stimuli, such as coughing, sneezing, yawning, and tears.

However, they are unable to have any activities such as consciousness, perception, and thinking . They cannot speak, move, or respond to the calls of family and friends.

Our cerebral cortex is where consciousness is generated. Any disease that damages the cerebral cortex and subcortical nerve conduction network may cause impaired consciousness, such as head trauma, stroke, hypoxic encephalopathy, etc.

Image source: Photo Network

It should be noted that "awakening" of a vegetative patient does not mean waking up all comatose patients, but rather conducting a strict assessment of them and screening suitable comatose patients in order to minimize the "suffering" of the patients and reduce "wasted money."

Image source: Photo Network

Moreover, the treatment of a vegetative patient is not like in TV dramas, where you sit next to the patient and chat with him, hoping the patient will be moved and wake up.

Currently, there are a variety of medical treatments that can help wake up a sleeping vegetative person, including:

1

Conventional treatment

1. Drug treatment:

Including various neurotransmitter regulating drugs such as amantadine, zolpidem, intrathecal baclofen, as well as auxiliary drugs such as neurotrophic and vasodilator drugs.

Although there are many types of drugs, their overall awakening-promoting effect is not certain. However, they are easy to obtain, widely used, and can be used in hospitals at all levels.

2. Hyperbaric oxygen therapy:

Hyperbaric oxygen therapy can increase the oxygen tension in brain tissue, promote the excitability of the ascending excitatory system of the brainstem reticular formation, promote the opening of collateral circulation, and facilitate neural repair and cognitive improvement. It can only be carried out in hospitals with the necessary conditions.

3. Neuromodulation therapy:

Neuromodulation therapy directly participates in the functional modulation of neural circuits through specific devices, and has the advantages of being reversible and controllable. In recent years, it has played an increasingly important role in the treatment of refractory neurological diseases, including non-invasive and surgical implantation methods.

In the 1-3 months after coma, non-invasive neuromodulation is usually used, including repetitive transcranial magnetic stimulation, transcranial direct current stimulation, peripheral nerve electrical stimulation, etc.

2

Surgical awakening therapy

Through surgery, specific devices are implanted in the human body to deliver electromagnetic stimulation or chemical stimulation to specific parts of the nervous system in a targeted manner, thereby changing neural activity.

Specific methods include:

(1) Deep brain stimulation (DBS);

(2) Spinal cord stimulation (SCS);

(3) Other stimulation methods: cortical electrical stimulation, vagus nerve stimulation (VNS) and baclofen pump implantation to promote wakefulness.

At present, the effectiveness of wake-up therapy is between 30% and 70%, and about half of the patients cannot ultimately achieve full wakefulness. Therefore , it is extremely rare for a person to suddenly wake up after sleeping for many years and be able to run and jump immediately, as shown in TV dramas.

But even so, after awakening treatment, many comatose patients can show improved consciousness and become more responsive .

The awakening treatment of a vegetative patient is like a protracted battle. Standardized assessment and a comprehensive and systematic treatment system play an important role in "awakening from coma".

Regarding awakening treatment, West China Hospital has something to say:

Professor Guan Junwen from the Department of Neurosurgery at West China Hospital has formed a multidisciplinary awakening team for chronic disorders of consciousness in collaboration with the Department of Critical Care Medicine, Department of Rehabilitation Medicine, and Department of Neuroimaging.

Patients can receive a preliminary assessment in Professor Guan Junwen's outpatient clinic and a detailed assessment after admission. Depending on the condition, they can be hospitalized and receive standardized treatment in the neurosurgery department, intensive care unit, rehabilitation department, etc.

Statement: This article is a medical-related educational popular science article. It does not involve specific treatment methods or medical behaviors and cannot replace hospital visits.

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Map: Eastern Zhou Dynasty