Skip to main content

To be or not to be ... Vegetative

  • Conference paper
Intensive Care Medicine
  • 953 Accesses

Abstract

The vegetative state is a clinical diagnosis first defined by Jennett and Plum in 1972 [1]. It is a diagnosis based on the absence of clinical signs of awareness of self or environment despite preserved arousal. That is, if a patient repeatedly fails to answer to commands and if all observed behavior is considered reflexive, the patient is considered to be unconscious.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Jennett B, Plum F (1972) Persistent vegetative state after brain damage. A syndrome in search of a name. Lancet 1:734–737

    Article  PubMed  CAS  Google Scholar 

  2. Giacino JT Ashwal S Childs N, et al (2002) The minimally conscious state: Definition and diagnostic criteria. Neurology 58:349–353

    PubMed  Google Scholar 

  3. Zeman A (2005) What in the world is consciousness? Prog Brain Res 150:1–10

    PubMed  Google Scholar 

  4. Andrews K (1996) International Working Party on the Management of the Vegetative State: summary report. Brain Inj 10:797–806

    Article  PubMed  CAS  Google Scholar 

  5. Giacino JT (2005) The minimally conscious state: defining the borders of consciousness. Prog Brain Res 150:381–395

    PubMed  CAS  Google Scholar 

  6. Royal College of Physicians (2003) The vegetative state: guidance on diagnosis and management. Clin Med 3:249–254

    Google Scholar 

  7. The Quality Standards Subcommittee of the American Academy of Neurology (1995). Practice parameters: assessment and management of patients in the persistent vegetative state (summary statement). Neurology 45:1015–1018

    Google Scholar 

  8. Kobylarz EJ, Schiff ND (2005) Neurophysiological correlates of persistent vegetative and minimally conscious states. Neuropsychol Rehabil 15:323–332

    Article  PubMed  Google Scholar 

  9. Giacino JT, Trott CT (2004) Rehabilitative management of patients with disorders of consciousness: grand rounds. J Head Trauma Rehabil 19:254–265

    PubMed  Google Scholar 

  10. Tresch DD, Sims FH, Duthie EH, Goldstein MD, Lane PS (1991) Clinical characteristics of patients in the persistent vegetative state. Arch Intern Med 151:930–932

    Article  PubMed  CAS  Google Scholar 

  11. Childs NL, Mercer WN, Childs HW (1993) Accuracy of diagnosis of persistent vegetative state. Neurology 43:1465–1467

    PubMed  CAS  Google Scholar 

  12. Andrews K, Murphy L, Munday R, Littlewood C (1996). Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit. BMJ 313:13–16

    PubMed  CAS  Google Scholar 

  13. Kampfl A, Schmutzhard E, Franz G, et al (1998) Prediction of recovery from post-traumatic vegetative state with cerebral magnetic-resonance imaging. Lancet 351:1763–1767

    Article  PubMed  CAS  Google Scholar 

  14. van der Naalt J, Hew JM, van Zomeren AH, Sluiter WJ, Minderhoud JM (1999). Computed tomography and magnetic resonance imaging in mild to moderate head injury: early and late imaging related to outcome. Ann Neurol 46:70–78

    Article  PubMed  Google Scholar 

  15. Carpentier A, Galanaud D, Puybasset L, et al (2006) Early morphologic and spectroscopic magnetic resonance in severe traumatic brain injuries can detect “invisible brain stem damage” and predict “vegetative states”. J Neurotrauma 23:674–685

    Article  PubMed  Google Scholar 

  16. The Multi-Society Task Force on PVS (1994) Medical aspects of the persistent vegetative state (1). N Engl J Med 330:1499–1508

    Article  Google Scholar 

  17. Danze F, Brule JF, Haddad K (1989) Chronic vegetative state after severe head injury: clinical study; electrophysiological investigations and CT scan in 15 cases. Neurosurg Rev 12(Suppl 1): 477–499

    Article  PubMed  Google Scholar 

  18. Hansotia PL (1985) Persistent vegetative state. Review and report of electrodiagnostic studies in eight cases. Arch Neurol 42:1048–1052

    PubMed  CAS  Google Scholar 

  19. Shuttleworth E (1983) Recovery to social and economic independence from prolonged post-anoxic vegetative state. Neurology 33:372–374

    PubMed  CAS  Google Scholar 

  20. Higashi K, Sakata Y, Hatano M et al (1977) Epidemiological studies on patients with a persistent vegetative state. J Neurol Neurosurg Psychiatry 40:876–885

    Article  PubMed  CAS  Google Scholar 

  21. Attia J, Cook DJ (1998) Prognosis in anoxic and traumatic coma. Crit Care Clin 14:497–511

    Article  PubMed  CAS  Google Scholar 

  22. Guerit JM (2005) Evoked potentials in severe brain injury. Progr Brain Res 150:415–426

    Google Scholar 

  23. Schiff ND, Ribary U, Moreno DR, et al (2002) Residual cerebral activity and behavioural fragments can remain in the persistently vegetative brain. Brain 125:1210–1234

    Article  PubMed  Google Scholar 

  24. Laureys S, Goldman S, Phillips C, et al (1999) Impaired effective cortical connectivity in vegetative state: preliminary investigation using PET. Neuroimage 9:377–382

    Article  PubMed  CAS  Google Scholar 

  25. Laureys S, Lemaire C, Maquet P, Phillips C, Franck G (1999) Cerebral metabolism during vegetative state and after recovery to consciousness. J Neurol Neurosurg Psychiatry 67:121

    PubMed  CAS  Google Scholar 

  26. Laureys S (2005) The neural correlate of (un)awareness: lessons from the vegetative state. Trends Cogn Sci 9:556–559

    Article  PubMed  Google Scholar 

  27. Laureys S, Owen AM, Schiff ND (2004) Brain function in coma, vegetative state, and related disorders. Lancet Neurol 3:537–546

    Article  PubMed  Google Scholar 

  28. Laureys S, Faymonville ME, Peigneux P, et al (2002) Cortical processing of noxious somato-sensory stimuli in the persistent vegetative state. Neuroimage 17:732–741

    Article  PubMed  CAS  Google Scholar 

  29. Laureys S, Faymonville ME, Degueldre C, at al (2000) Auditory processing in the vegetative state. Brain 123:1589–1601

    Article  PubMed  Google Scholar 

  30. Boly M, Faymonville ME, Peigneux P, et al (2004) Auditory processing in severely brain injured patients: differences between the minimally conscious state and the persistent vegetative state. Arch Neurol 61:233–238

    Article  PubMed  Google Scholar 

  31. Hinterberger T, Wilhelm B, Mellinger J, Kotchoubey B, Birbaumer N (2005) A device for the detection of cognitive brain functions in completely paralyzed or unresponsive patients. IEEE Trans Biomed Eng 52:211–220

    Article  PubMed  Google Scholar 

  32. Kotchoubey B (2005) Event-related potential measures of consciousness: two equations with three unknowns. Prog Brain Res 150:427–444

    PubMed  Google Scholar 

  33. Kotchoubey B (2005) Apallic syndrome is not apallic: is vegetative state vegetative? Neuropsychol Rehabil 15:333–356

    Article  PubMed  Google Scholar 

  34. Perrin F, Schnakers C, Schabus M, et al (2006) Brain response to one’s own name in vegetative state, minimally conscious state, and locked-in syndrome. Arch Neurol 63:562–569

    Article  PubMed  Google Scholar 

  35. de Jong B, Willemsen AT, Paans AM (1997) Regional cerebral blood flow changes related to affective speech presentation in persistent vegetative state. Clin Neurol Neurosurg 99:213–216

    Article  PubMed  Google Scholar 

  36. Menon DK, Owen AM, Williams EJ, et al (1998) Cortical processing in persistent vegetative state. Wolfson Brain Imaging Centre Team. Lancet 352:200

    Article  PubMed  CAS  Google Scholar 

  37. Laureys S, Perrin F, Faymonville ME, et al (2004) Cerebral processing in the minimally conscious state. Neurology 63:916–918

    PubMed  CAS  Google Scholar 

  38. Owen AM, Coleman MR, Menon DK, et al (2005) Using a hierarchical approach to investigate residual auditory cognition in persistent vegetative state. Prog Brain Res 150:457–471

    PubMed  Google Scholar 

  39. Schiff ND, Ribary U, Moreno DR, et al (2002) Residual cerebral activity and behavioural fragments can remain in the persistently vegetative brain. Brain 125:1210–1234

    Article  PubMed  Google Scholar 

  40. Schiff N, Ribary U, Plum F, Llinás R (1999) Words without mind. J Cogn Neursci 11:650–656

    Article  CAS  Google Scholar 

  41. Kotchoubey B, Lang S, Mezger G, et al (2005) Information processing in severe disorders of consciousness: vegetative state and minimally conscious state. Clin Neurophysiol 116:2441–2453

    Article  PubMed  CAS  Google Scholar 

  42. Owen AM, Coleman MR, Boly M, Davis MH, Laureys S, Pickard JD (2006) Detecting awareness in the vegetative state. Science 313:1402

    Article  PubMed  CAS  Google Scholar 

  43. Laureys S (2005) Science and society: death, unconsciousness and the brain. Nat Rev Neurosci 6:899–909

    Article  PubMed  CAS  Google Scholar 

  44. Majerus S, Gill-Thwaites H, Andrews K, Laureys S (2005). Behavioral evaluation of consciousness in severe brain damage. Prog Brain Res 150:397–413

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer Science + Business Media Inc.

About this paper

Cite this paper

Boly, M., Owen, A.M., Laureys, S. (2007). To be or not to be ... Vegetative. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-49518-7_83

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-49518-7_83

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-49517-0

  • Online ISBN: 978-0-387-49518-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics