The vegetative state: guidance on diagnosis and management.

1.3 A patient in the vegetative state (VS) appears at times to be wakeful, with cycles of eye closure and eye opening resembling those of sleep and waking. However, close observation reveals no sign of awareness or of a ‘functioning mind’: specifically, there is no evidence that the patient can perceive the environment or his/her own body, communicate with others, or form intentions. As a rule, the patient can breathe spontaneously and has a stable circulation. The state may be a transient stage in the recovery from coma or it may persist until death. The vegetative state can follow a variety of severe insults to the brain, most commonly traumatic or hypoxic-ischaemic brain injuries.

• Publication year

  2003

• Venue

  Clinical medicine (London)

• Publication date

  Unknown publication date

• Fields of study

  Medicine

• Identifiers
  DOI 10.7861/clinmedicine.3-3-249PMID 12848260PMCID PMC4952451
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• The minimally conscious state: Definition and diagnostic criteria

  2002cited by this paper
• Residual cerebral activity and behavioural fragments can remain in the persistently vegetative brain.

  2002cited by this paper
• The minimally conscious state: definition and diagnostic criteria.

  2002cited by this paper
• PERMANENT VEGETATIVE STATE AND THE LAW

  2001cited by this paper
• Cerebral Function in Coma, Vegetative State, Minimally Conscious State, Locked-in Syndrome, and Brain Death

  2001cited by this paper
• The Wessex Head Injury Matrix (WHIM) main scale: a preliminary report on a scale to assess and monitor patient recovery after severe head injury

  2000cited by this paper
• The Sensory Modality Assessment and Rehabilitation Technique (SMART): A Comprehensive and Integrated Assessment and Treatment Protocol for the Vegetative State and Minimally Responsive Patient

  1999cited by this paper
• Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit

  1996cited by this paper
• Accuracy of diagnosis of persistent vegetative state

  1993cited by this paper
• Persistent vegetative state

  1993cited by this paper
• Persistent vegetative state after brain damage.

  1972cited by this paper

• Detecting awareness after acute brain injury.

  2024cites this paper
• Natural course and predictors of consciousness recovery in children with prolonged disorder of consciousness

  2024cites this paper
• Functional hub disruption emphasizes consciousness recovery in severe traumatic brain injury

  2023cites this paper
• Thought experiments, sentience, and animalism

  2023cites this paper
• Educational challenges of family caregivers of vegetative state patients for home care preparedness: A qualitative content analysis

  2022cites this paper
• Links Between Swallowing and Consciousness: A Narrative Review

  2022cites this paper
• Behavioral signs of recovery from unresponsive wakefulness syndrome to emergence of minimally conscious state after severe brain injury.

  2021cites this paper
• Analyzing the paradigmatic cases of two persons with a disorder of consciousness: reflections on the legal and ethical perspectives

  2021cites this paper
• CIRCADIAN RHYTHM AND CHRONIC DISORDERS OF CONSCIOUSNESS

  2021cites this paper
• Transcranial Direct Current Stimulation in Disorders of Consciousness

  2021cites this paper
• Individualized Prognostic Prediction of the Long-Term Functional Trajectory in Pediatric Acquired Brain Injury

  2021cites this paper
• Pain Perception in Disorder of Consciousness: A Scoping Review on Current Knowledge, Clinical Applications, and Future Perspective

  2021cites this paper
• Auditory localization should be considered as a sign of minimally conscious state based on multimodal findings

  2020cites this paper
• Joint Neuropsychological Assessment through Coma/Near Coma and Level of Cognitive Functioning Assessment Scales Reduces Negative Findings in Pediatric Disorders of Consciousness

  2020cites this paper
• Chronic disorders of consciousness: terminology and diagnostic criteria. The results of the first meeting of the Russian Working Group for Chronic Disorders of Consciousness

  2020cites this paper
• PET Imaging in Altered States of Consciousness: Coma, Sleep, and Hypnosis

  2020cites this paper
• [Results of treatment with intravenous amantadine sulfate (PK-Merz) patients with chronic disorders of consciousness].

  2020cites this paper
• Neuroimaging Studies on Disorders of Consciousness: A Meta-Analytic Evaluation

  2019cites this paper
• Management of Severely Brain-Injured Patients Recovering from Coma in the Neurocritical Care Unit

  2019cites this paper
• Can Salient Stimuli Enhance Responses in Disorders of Consciousness? A Systematic Review

  2019cites this paper
• Feasibility Randomized Trial for an Intensive Memory-Focused Training Program for School-Aged Children with Acquired Brain Injury

  2019cites this paper
• Is oral feeding compatible with an unresponsive wakefulness syndrome?

  2018cites this paper
• Visual pursuit of one’s own face in disorders of consciousness: a quantitative analysis

  2018cites this paper
• Conscious While Being Considered in an Unresponsive Wakefulness Syndrome for 20 Years

  2018cites this paper
• Consciousness and Personhood in Medical Care

  2018cites this paper
• Is telemonitoring useful for supporting persons with consciousness disorders and caregivers? A preliminary observational study in a real-life population

  2018cites this paper
• Dead-Survivors, the Living Dead, and Concepts of Death

  2018cites this paper
• Potential benefits of zolpidem in disorders of consciousness

  2017cites this paper
• A diffusion tensor magnetic resonance imaging study of paediatric patients with severe non‐traumatic brain injury

  2017cites this paper
• EEG and fMRI agree: Mental arithmetic is the easiest form of imagery to detect.

  2017cites this paper
• Minimally conscious state or cortically mediated state?

  2017cites this paper
• De la recherche d’une réaction, au guidage, la stimulation comme outil lors d’une prise en charge auprès de patients non ou peu communicants

  2017cites this paper
• Decoding Mental States after Severe Brain Injury

  2017cites this paper
• A Fate Worse Than Death? The Well-Being of Patients Diagnosed as Vegetative With Covert Awareness

  2017cites this paper
• Analysis of Italian regulations on pathways of care for patients in a vegetative or minimally conscious state.

  2017cites this paper
• Repeated transcranial direct current stimulation in prolonged disorders of consciousness: A double-blind cross-over study.

  2017cites this paper
• A comparative study on assessment procedures and metric properties of two scoring systems of the Coma Recovery Scale-Revised items: standard and modified scores

  2017cites this paper
• Coma and disorders of consciousness.

  2017cites this paper
• More dead than dead? Attributing mentality to vegetative state patients

  2016cites this paper
• Changes over time in the quality of life, prolonged grief and family strain of family caregivers of patients in vegetative state: A pilot study

  2016cites this paper
• A hierarchy of event-related potential markers of auditory processing in disorders of consciousness

  2016cites this paper
• The Chief Role of Frontal Operational Module of the Brain Default Mode Network in the Potential Recovery of Consciousness from the Vegetative State: A Preliminary Comparison of Three Case Reports

  2016cites this paper
• Vita tua, mors mea: The experience of family caregivers of patients in a vegetative state

  2016cites this paper
• The Moral Status and Welfare of Patients Diagnosed as Vegetative With Covert Awareness

  2016cites this paper
• Relative Values: Perspectives on a Neuroimaging Technology From Above and Within the Ethical Landscape

  2016cites this paper
• Somatosensory attention identifies both overt and covert awareness in disorders of consciousness

  2016cites this paper
• Long-Term (Six Years) Clinical Outcome Discrimination of Patients in the Vegetative State Could be Achieved Based on the Operational Architectonics EEG Analysis: A Pilot Feasibility Study

  2016cites this paper
• Resting-state networks distinguish locked-in from vegetative state patients

  2016cites this paper
• ADVANCES IN THE ASSESSMENT OF DISORDERS OF CONSCIOUSNESS : THE ROLE OF BEDSIDE ASSESSMENT AND NEUROIMAGING TECHNIQUES IN THE DIAGNOSTIC PROCESS

  2016influential citation
• Caregivers of patients with disorder of consciousness: burden, quality of life and social support

  2015cites this paper
• Boosting Cognition With Music in Patients With Disorders of Consciousness

  2015cites this paper
• Quand la musique se fait l'écho du Soi ! : études des effets d’un contexte musical autobiographique sur l’activité cérébrale de patients en coma et éveil de coma et de sujets sains

  2015cites this paper
• A Single Session of Repetitive Transcranial Magnetic Stimulation Over the Dorsolateral Prefrontal Cortex in Patients With Unresponsive Wakefulness Syndrome

  2015cites this paper
• Serial measurement of Wessex Head Injury Matrix in the diagnosis of patients in vegetative and minimally conscious states: a cohort analysis

  2015cites this paper
• Remaining unconscious: The burden of traumatic brain injuries in India

  2015cites this paper
• Epicurean aspects of mental state attributions

  2015cites this paper
• LOCFAS–Assessed Evolution of Cognitive and Behavioral Functioning in a Sample of Pediatric Patients With Severe Acquired Brain Injury in the Postacute Phase

  2015cites this paper
• Across the consciousness continuum—from unresponsive wakefulness to sleep

  2015cites this paper
• Death, treatment decisions and the permanent vegetative state: evidence from families and experts

  2014cites this paper
• Caregiving for Patients in Vegetative and Minimally Conscious States: Perceived Burden as a Mediator in Caregivers’ Expression of Needs and Symptoms of Depression and Anxiety

  2014cites this paper
• The Prevalence of Vegetative and Minimally Conscious States: A Systematic Review and Methodological Appraisal

  2014cites this paper
• Intentional Action and the Post-Coma Patient

  2014cites this paper
• Spectrum of catastrophic brain injury: coma and related disorders of consciousness.

  2014cites this paper
• Brain activation by music in patients in a vegetative or minimally conscious state following diffuse brain injury

  2014cites this paper
• The importance of polysomnography in the evaluation of prolonged disorders of consciousness: sleep recordings more adequately correlate than stimulus-related evoked potentials with patients' clinical status.

  2014cites this paper
• Dorsal Co l umn Stimulation in Persistent Vegetative State ( P VS )

  2014cites this paper
• Common Complications after Hypoxic-ischemic Encephalopathy

  2014cites this paper
• Has the sanctity of life law ‘gone too far’?: analysis of the sanctity of life doctrine and English case law shows that the sanctity of life law has not ‘gone too far’

  2014cites this paper
• Recherche de signes de conscience chez des malades non communicants : une approche clinique et électrophysiologique

  2014cites this paper
• Questioning the dichotomy between vegetative state and minimally conscious state: a review of the statistical evidence

  2014cites this paper
• Long-lasting coma.

  2014cites this paper
• How the burden of caring for a patient in a vegetative state changes in relation to different coping strategies

  2014cites this paper
• ICF-DOC: the ICF dedicated checklist for evaluating functioning and disability in people with disorders of consciousness

  2014cites this paper
• Intensive physiotherapy for vegetative and minimally conscious state patients: a retrospective audit and analysis of therapy intervention

  2013cites this paper
• Dissociation of Vegetative and Minimally Conscious Patients Based on Brain Operational Architectonics

  2013cites this paper
• Attitudes of Lay People to Withdrawal of Treatment in Brain Damaged Patients

  2013cites this paper
• Abnormal corticospinal excitability in patients with disorders of consciousness.

  2013cites this paper
• The complementary role of music therapy in the detection of awareness in disorders of consciousness: An audit of concurrent SMART and MATADOC assessments

  2013cites this paper
• An Italian population study on 600 persons in vegetative state and minimally conscious state

  2013cites this paper
• From Hope to Despair, and Back

  2013cites this paper
• Prognostic Value of Resting-State Electroencephalography Structure in Disentangling Vegetative and Minimally Conscious States

  2013cites this paper
• Detecting awareness after severe brain injury

  2013cites this paper
• Detecting consciousness: a unique role for neuroimaging.

  2013cites this paper
• Finding a way in: a review and practical evaluation of fMRI and EEG for detection and assessment in disorders of consciousness.

  2013cites this paper
• Advance Directive from the Romanian Social Cultural Perspective Iasi: Editura Lumen, 2013 (English version)

  2013cites this paper
• The Effect of Positioning on the Level of Arousal and Awareness in Patients in the Vegetative State or the Minimally Conscious State: A Replication and Extension of a Previous Finding

  2013cites this paper
• Intentional Action and the Post-Coma Patient

  2013cites this paper
• Detection and Management of Pain and Suffering in Disorders of Consciousness

  2013cites this paper
• Functioning and disability of children and adolescents in a vegetative state and a minimally conscious state: identification of ICF-CY-relevant categories

  2012cites this paper
• HISTORICAL EVOLUTION OF MEDICAL KNOWLEDGE IN THE FIELD OF VEGETATIVE STATE

  2012cites this paper
• Case Law on Artificial Nutrition and Hydration Since Bland

  2012cites this paper
• Clinical differentiation and outcome evaluation in vegetative and minimally conscious state patients:the neurophysiological approach.

  2012cites this paper
• Quantitative assessment of visual behavior in disorders of consciousness

  2012cites this paper
• Children in Vegetative State and Minimally Conscious State: Patients' Condition and Caregivers' Burden

  2012cites this paper
• How family caregivers' medical and moral assumptions influence decision making for patients in the vegetative state: a qualitative interview study

  2012cites this paper
• Diagnostic and ethical challenges in disorders of consciousness and locked-in syndrome: a survey of German neurologists

  2012cites this paper
• DMN Operational Synchrony Relates to Self-Consciousness: Evidence from Patients in Vegetative and Minimally Conscious States

  2012cites this paper
• Caring for a Head-Injured Patient with Terminal Agitation in A&E

  2012cites this paper
• Detecting Awareness in the Vegetative State: Electroencephalographic Evidence for Attempted Movements to Command

  2012cites this paper
• A role for the default mode network in the bases of disorders of consciousness

  2012cites this paper