How to recover from coma, minimally conscious state and vegetative state?

  The main goals of rehabilitation are adequate stabilization, preservation of physical integrity, and objective clarification of the patient’s current sensory and cognitive abilities through monitoring. Maintaining a clear airway as well as skin integrity; preventing infections; prevention and treatment of hypertonia and contractures; prevention and control of hyperthermia, seizures, etc.; ensuring adequate nutrition; and preventing and controlling complications (e.g., stress ulcers, hydrocephalus, etc.). By preventing the development of severe deformities, the recovering patient can save a lot of time and money. Finally, sedative medications should be avoided until the prognosis is clear. This includes various antitussive, anticonvulsant, antihypertensive, anticholinergic, and antihistamines, which may have subtle cognitive effects in susceptible patients. Quantitative rating scales should be routinely used to help modify rehabilitation programs in a timely manner.  The approach to rehabilitation is comprehensive wake-promoting rehabilitation, i.e., any treatment that does more good than harm to the patient, including: sensory stimulation (pain, sound, light, taste, smell, touch, proprioception, etc.), acupuncture, hyperbaric oxygen (the effect is not clear, but it can be tried), electrical stimulation (including spinal cord electrical stimulation (e.g., cervical spinal epidural stimulation), deep brain stimulation, peripheral nerve stimulation (including median nerve stimulation, vagus nerve stimulation) stimulation, vagus nerve stimulation, etc.), environmental stimulation, affection therapy, Chinese medicine treatment, etc.  In addition, transcranial direct current stimulation, as a treatment that can improve the excitability of cortical cells, can be used to promote wakefulness in patients with disorders of consciousness. This technique can improve the excitability of the cortical cells at the stimulated site, so that the cortical nerve cells can re-establish complex network behaviors and facilitate the awakening process of the patient.