14 - Persistent Vegetative State

Question 1

Consciousness

Answer 1

State of full awareness of the self and one’s relationship to the environment

Question 2

Reticular activating system

Answer 2

• Rostral midbrain and mid pons
• Project to subthalamus, hypothalamus, Thalamus and basal forebrain – Cerebral cortex
• Heterotopic group of cholinergic, noradrenergic, orexinergic

Question 3

What is a vegetative state

Answer 3

patient appears to be awake but shows no sign of awareness of themselves or their environment.

Question 4

Minimal Consciousness state

Answer 4

Wakefulness accompanied by inconsistent but reproducible signs of awareness
 Non reflexic response to sensory stimulus.
 Awareness of self or environment.
 Language comprehension or expression
 Visual tracking
 Lack of object use

Question 5

What is Akinetic Mutism

Answer 5

Minimal conscious state whereby the patient is awake and diminished drive to respond

Question 6

When is someone considered to be in a persistent vegetative state

Answer 6

More than 1 month
more than 12 months for trauma
more than 6 months for anoxic

Question 7

How is vegetative state diagnosed

Answer 7

Observable behaviout features
Clinical history
imaging

Question 8

Diagnostic criteria of vegetative state

Answer 8

o Cycles of eye opening and closing giving the appearance of sleep wake cycle.
o Complete lack of self or environment.
o Complete or partial preservation of hypothalamic and brain stem autonomic functions

Question 9

sLEEP EEG of someone in VS

Answer 9

decline of slow wave, REM in MCS

Question 10

Factors that influence recovery

Answer 10

Time in vegetative state
Age
Type of brain injury - traumatic has a better outcome

Question 11

What drugs are given to relax the muscle

Answer 11

Amantadine

Zolpidem

Question 12

What surgical procedure can be done

Answer 12

Central thalamic deep brain stimulator