Reviving Coma Patients
In light of the breaking news last week that a 38-year-old man regained speech after brain stimulation, we asked Craig Panner, our in-house expert on all things science and a senior-editor at OUP, what his thoughts were. He immediately thought of Plum and Posner’s Diagnosis of Stupor and Coma 4th edition because Nicholas Schiff, one of the co-authors, was deeply involved in the study that led to brain stimulation. Below is Panner’s first OUPblog post.
It was 25 years in the making for the new edition of Plum and Posner’s Diagnosis of Stupor and Coma (J. Posner, C. Saper, N. Schiff, and F. Plum) to come to fruition. During those 25 years, the previous edition continued to sell while people repeatedly asked for an update that they, as well as their residents, could use. But the continuing development of knowledge and treatment options made it a difficult “to put the book to bed.” In early 2007, the book published to great reception and reviews and the recent Nature article (Volume 488, 7153, page 600) by the co-author Nicholas Schiff only solidifies the importance of understanding stupor and coma as well as the ever-evolving treatment options.
5 things to know about Deep Brain Stimulation (DBS)
1. The use of DBS as a treatment in coma is only experimental at this time. The results presented in the Nature article were based on only 1 patient.
2. DBS is a last-resort option when various drugs have no effect.
3. DBS does not damage the brain but the brain does need to be healthy (many high profile cases in the news have had severely damaged brains where DBS would have no effect)
4. DBS results in 2 surgeries: one in the brain and one in the chest (to implant a neurostimulator)
5. DBS does not work immediately but rather requires adjustments to the neurostimulator to find the right level of stimulation.