[Vegetative or minimally conscious state?].
We describe the clinical course of a 51-year-old woman in a vegetative state and of a 63-year-old woman in a minimally conscious state. The difference between these two states is an important one, as clinical course, prognosis and medical-ethical considerations of both are different. In practice it is difficult to distinguish between a vegetative state and a minimally conscious state, but the use of a Post-Acute Level of Consciousness scale helps to illustrate the differences. Expertise, research, and application of functional neuro-imaging techniques (PET, fMRI) might also be useful. The differences between these two states regarding rehabilitation, pain management and medical-ethical decisions are important. The effects of neuro-rehabilitation and the implications of a minimally conscious state for patients and their proxies need further investigation.
Sensire verpleeghuis Den Ooiman, Doetinchem, the Netherlands.
Berno U H
BU
Overbeek
Jan C M
JC
Lavrijsen
Henk J
HJ
Eilander
D001364:Awareness; D001921:Brain / Q000473:pathology; D003244:Consciousness Disorders / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004594:Electrophysiology; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000175:diagnosis*; D049268:Positron-Emission Tomography; D011379:Prognosis