Hyperbaric oxygen therapy in neurological disorders

Hyperbaric oxygen (HBO) therapy has been introduced as an alternative and c ontroversial therapy in a number of disease entities over the last years. T his review article addresses the scientific evidence of the efficacy of HBO in neurological disorders. HBO has been investigated in a large number of clinical trials. However, on ly a minority of these studies fulfill the requirements of a satisfactory s tudy protocol. Furthermore, controversial study results do not help clinici ans to accept HBO as a valuable therapeutical approach in most neurological disorders. Acute decompression sickness with neurological symptoms and severe CO intox ication are accepted as absolute emergency indications for HBO. A possible indication does exist for tinnitus, lasting less than three months, In pati ents with therapy-resistant cluster headache HBO should be considered. HBO is not helpful in the treatment of multiple sclerosis. Despite potential th eoretical considerations and animal-based evidence of efficacy, HBO does no t appear to be of advantage in patients with acute stroke. The value of HBO for post-stroke rehabilitation appears to be limited. HBO improves the sur vival rate after brain injury. However, the surviving patients suffer sever e disability, and HBO has not succeeded as a standard neurosurgical therape utic approach.