Epidemiological studies on patients with a persistent vegetative state

Abstract

(Nakamura et al., 1965a,b;Crompton et al., 1966), coma vigile (Gerstenbrand, 1967), parasomnia (Jefferson, 1944), akinetic mutism (Cairns et al., 1941), and apallic syndrome (Kretschmer, 1940). Recently, Jennett and Plum (1972) We arbitrarily designed the following criteria in order to study such patients: (1) defect of verbal and behavioural communication; (2) loss of expression of intention; (3) absence, or at least reduction of emotional expression; (4) urinary and faecal incontinence; (5) complete loss of selfsupportability; (6) continuation of above conditions for more than three months, regardless of causative disease. Patients and methodsIn response to simple inquiries to 269 hospitals in 16 prefectures of western Japan on 1 June 1973, 193 potentially suitable cases were reported from 189 hospitals; we then visited each hospital and examined each patient. Based on the above criteria, 110 patients were included in our study.Although we were unable to assess the incidence of vegetative patients for all districts responding to our inquiry our survey did cover all hospitals within Yamaguchi prefecture, a population of approximately 1.5 million. We found 37 vegetative patients, an incidence of 0.0025%.We examined the behaviour, response to various stimuli, and neurological signs of the 110 patients in our sample. Analyses were also made of the results of ancillary examinations, methods of management of the patients, and effectiveness of treatment given. In order to assess the level of 876

Events and decision-making in the long-term care of Dutch nursing home patients in a vegetative state

“…Comparison with the few other studies of longterm care is impossible, because these include developmental or degenerative disorders [14][15][16]. Single case reports have shown similar co-morbidity (constipation, contractures and infections) [17][18][19][20].…”

Vegetative State and Minimally Conscious State: A Review of the Therapeutic Interventions

“…For instance, positive effects of levodopa on the level of consciousness were observed by Higashi et al [32] in 1977. Also, DBS for DOC has a long and interesting history [33] .…”

Neuroimaging and Outcome Assessment in Vegetative and Minimally Conscious State

“…In around 10% of patients with VS, the EEG is nearly normal late in the course of disease but without evidence of vision-induced alpha blocking (Danze et al, 1989). There have been occasional reports of isoelectric EEGs in patients in a VS, although it has not been confirmed (Higashi et al, 1977;Mizrahi et al, 1985). Typical epileptiform activity is unusual in patients in VS, as seizure activity is (The Multi-Society Task Force on PVS, 1994).…”