An unexpected recovery from permanent vegetative state.
OBJECTIVE
To challenge the Multi-Society Task Force's ruling that a persistent vegetative state (PVS) can be judged to be permanent for non traumatic brain injury after three months.


METHODS
We report the case of a 44-year-old man who had recovery of consciousness with persistent severe disability 19 months after a non-traumatic brain injury at least in part triggered and maintained by intrathecal baclofen administration.


RESULTS
This unexpected and late recovery of consciousness raises an interesting hypothesis of possible effects of partially regained spinal cord outputs on reactivation of cognition.


CONCLUSIONS
Considering that several ethical, legal, and socio-economic issues have been raised about the opportunity of withdrawing treatment and life support in patients with PVS the report of this case might add further documentation to the ongoing debate.
Sarà
Marco
M
Istituto San Raffaele-Tosinvest Sanità. Post-Coma Intensive and Rehabilitation Care Unit, Cassino. marco.sara@sanraffaele.it
Sacco
Simona
S
Cipolla
Francesco
F
Onorati
Paolo
P
Scoppetta
Ciriaco
C
Albertini
Giorgio
G
Carolei
Antonio
A
D000328:Adult; D001418:Baclofen / Q000627:therapeutic use*; D003243:Consciousness; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009125:Muscle Relaxants, Central / Q000627:therapeutic use*; D009128:Muscle Spasticity / Q000188:drug therapy; D018458:Persistent Vegetative State / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D011379:Prognosis; D020127:Recovery of Function; D013997:Time Factors
D009125:Muscle Relaxants, Central; D001418:Baclofen