Problem: Can stimulation of nerve growth factors by focused transcranial extracorporeal shock waves (TESW) for persons within unresponsive wakefulness syndrome (apallic syndrome) be made effective? Patients and Methods: Five patients with apallic syndrome of differing severity received 7-17 years after their accident on average 4.4 4 week physicomedical complex treatment series including focused extracorporeal shock waves (device Duolith Storz Medical) for the spastic muscles. After this an enhancement of the vigilance could not be seen. Then these complex therapies were augmented by transcranial focused extracorporal shock waves (TESW). During 2-4 years the same patients received on average 5.2 TESW. Before and after the treatment series the patients were tested with the German Coma remission scale (CRS) and the German scale Expressive Communication and Self Actualisation (SEKS, Ziegler). Results: The patients improved their abilities by 135.9% on the CRS and by 81.7% on SEKS. Three PEG feeding tubes could be removed, nonverbal communication initiated 4 times. Discussion: Possible mode of actions and relation to other non invasive methods of brain stimulation are discussed. Conclusion: TESW seem to stimulate vigilance and the motoric in patients with apallic syndrome. A possible placebo effect and the neurophysiological must be verified.