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A vegetative state (VS) or post-coma unresponsiveness (PCU) [1] is a disorder of consciousness in which patients with severe brain damage are in a state of partial arousal rather than true awareness. After four weeks in a vegetative state, the patient is classified as being in a persistent vegetative state (PVS).
In 1994, this South African switchboard operator fell into a persistent vegetative state after being hit by a truck while riding his bike. In 1999, Dr. Wally Nel gave him Zolpidem (also known as Ambien) after a nurse told Viljoen's mother that involuntary spasms in his left arm had caused him to tear his mattress and that this could have been ...
Vegetative symptoms are disturbances of a person's functions necessary to maintain life (vegetative functions). These disturbances are most commonly seen in mood disorders , and are part of the diagnostic criteria for depression , but also appear in other conditions.
In general patients surviving a coma recover gradually within 2–4 weeks. But recovery to full awareness and arousal is not always possible. Some patients do not progress further than vegetative state or minimally conscious state and sometimes this also results in prolonged stages before further recovery to complete consciousness. [17]
Time is the best general predictor of a chance of recovery. For example, after four months of coma caused by brain damage, the chance of partial recovery is less than 15%, and the chance of full recovery is very low. [50] The outcome for coma and vegetative state depends on the cause, location, severity and extent of neurological damage.
The Glasgow Outcome Scale (GOS) is an ordinal scale used to assess functional outcomes of patients following brain injury. It considers several factors, including a patient's level of consciousness, ability to carry out activities of daily living (ADLs), and ability to return to work or school.
In children, the most common cause is a stroke of the ventral pons. [9]Unlike persistent vegetative state, in which the upper portions of the brain are damaged and the lower portions are spared, locked-in syndrome is essentially the opposite, caused by damage to specific portions of the lower brain and brainstem, with no damage to the upper brain.
The vegetative state is considered permanent if it persists for 12 months after TBI or 3 months after causes other than trauma. [ 6 ] A minimally conscious state is a condition in which patients have a reduced level of arousal and may appear, on the surface, to be in a persistent vegetative state but are capable of demonstrating the ability to ...