We are very happy to contribute to the recovery of a 30-year-old coma patient.
Our doctor Prof. Halil Özcan, who has significant progress on tVNS clinical studies, tells the story of a miraculous treatment that took place in the Neuromodulation department of Erzurum Atatürk University:
"A 30-year-old woman, teacher, was referred to our hospital from the private hospital where she gave birth 15 months ago due to postpartum sinus vein thrombosis and cerebral hemorrhage (in the right temporal region), with glasgow coma score 5, unconsciousness and complete paralysis.
After 1 month in the intensive care unit, in the fourth month of his stay in the palliative care unit, the patient was consulted to a psychiatrist, whose general condition was poor, eyes were spontaneously open, but had an unresponsive glasgow coma score of 7 and spontaneous crying. At that time, the patient was fed with a duodenal tube and had spontaneous breathing. The patient, who had epileptic seizures twice, was therefore using valproic acid 2000 mg and levetiracetam 3000 mg. She occasionally used various antibiotics, painkillers and proton pump inhibitors, and lotions for skin care, oral care, etc. A year ago, when the patient was first examined, no communication could be established, so the reason of crying could not be clarified. Escitalopram 10 mg was started as an antidepressant. Alprazolam 1 mg/day and pregabalin 2x25 mg/day were added to the treatment of the patient who did not respond to previous medication.
In the meantime, it was reported to his family that there are patients in vegetative state and coma in the world, who have been treated with vagal nerve stimulation and obtained significant progress. The application was started after the family approval. Considering the limited available literature, we decided to use both transauricular vagus nerve stimulation (tvns) and transcranial direct current stimulation (tdcs) treatments together, as it was thought to be more beneficial. We used tVNS®-R from tVNS Technologies , 25 hertz continuous stimulation to the left ear cymba conchae region, 1-3 hours a day in the range of 100-3000 microamperes. And (tdcs -apex type A) 2 milliamper anode cathode close to the right temporal lobe. It was placed in the left orbitofrontal cortex and the application was made with continuous stimulation for 20 minutes. The application was planned to be 5 days a week (weekdays).
In the 4th month of the treatment, we recommended to stop tVNS therapy, since no significant benefit was observed. However, the application was continued after family stated that they saw positive changes in the patient (as if she was looking at us, she understood what we were saying, etc.). In the 6th month of the treatment, spontaneous movements in the right leg of the patient and eye contact was observed and she tried to lift her leg.
Therapy continued after this pleasing development. One month later, the patient made a complete sentence (she said, 'Daddy, will you give me coffee?', they had used to drink coffee with her father before). After this amazing progress, the patient's cognitive and speech improved day by day. Finally, the patient's left leg and head began to move. Glasgow coma score become 15 full points. As of now, the patient's speech is mildly dysarthric, but she can understand what is being said and can easily give appropriate answers. The patient's treatment continues in the palliative unit after 15th month in our hospital. tVNS and tdcs therapies have completed 1 year and we continue for more improvement."
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