The effect of intense multi-sensory stimulation on coma arousal and recovery

Abstract

The purpose of this study was to evaluate the possible therapeutic benefits of intense multi-sensory stimulation (IMS) in the management of profound coma. Two hundred hospitalised patients with Glasgow Coma Scale (GCS) scores of 6 or less recorded on admission and 1 week later, were included in the IMS treatment programme. Twenty-seven patients were seen within the first month following injury and the onset of coma. The remaining 173 patients were first seen on average 6 months post-onset, with the longest period of coma extending to 2 years prior to IMS. All had a “hopeless” prognosis recorded on their charts and all were reported as being in a persistent vegetative state (PVS). Outcome results are compared with 33 patients (controls) of similar age, sex, and aetiological and GCS distribution who did not receive IMS; 34.5% of the IMS group made a moderate to good recovery based on Glasgow Outcome Scores (GOS), 9% have remained in PVS, 56.5% are still severely disabled with marked psychomotor deficits, but are out of coma and some are continuing to show progress. A total of 91% are out of coma; 33 patients in the control group (100%) remain in coma. The results of this study support earlier observations that the worst prognostic criteria do not apply uniformly to the patient in either acute or chronic coma, and that the outcome in both conditions can be markedly influenced by IMS.