BEHAVIOURAL AND EEG AROUSAL INDUCED BY STIMULATION OF UNSPECIFIC PROJECTION SYSTEMS IN A PATIENT WITH POST-TRAUMATIC APALLIC SYNDROME

A patient in a state of coma vigil from an apallic syndrome of 5 months' standing was treated by repeated stimulation of the right pallidum and basal portion of the left latero-polar nucleus of the thalamus (VA) by means of flexible electrodes inserted into these structures. Treatment lasted 19 days. Stimulation produced clinical arousal, with spontaneous movements of the left limbs, turning toward nearby persons and affective reactions with un-intelligible vocalization, between stimuli. Treatment resulted in a consistently higher level of consciousness, but no further gains were seen after removal of the electrodes at 19 days. EEG monitoring during treatment revealed the disappearance of a left temporal delta focus, reduction of the initial asymmetry and partial restoration of the alpha rhythm. Short bilateral stimuli (pallidum 8 c/sec, VA 50 c/sec) produced immediate desynchronization in all tracings. Stimulation of the left VA (25 c/sec) produced a predominatly ipsilateral acceleration of spontaneous activity with reduced amplitudes. © 1969.