A persistent vegetative state (or PVS) is a condition of patients with severe brain damage in whom coma has progressed to a state of "wakefulness without awareness". The term was introduced by two doctors in 1972 to describe a syndrome that seemed to have been made possible by medicine's increased capacities to keep patients' bodies alive. A persistent vegetative state is not the same as coma, the major distinction being that coma sufferers cannot breathe on their own.
Patients in a persistent vegetative state are usually considered to be unconscious and unaware, but exhibit sleep-wake cycles and some behaviors that can be construed as arising from partial consciousness, such as grinding their teeth, swallowing, smiling, shedding tears, grunting, moaning, or screaming without any apparent external stimulus. Their heads and eyes can track moving objects or turn towards a sound.
Few people ever recover from PVS, but in occasional cases, family members who visit the patient will detect evidence of awareness when doctors with limited patient contact will deny it. Eye tracking is often the earliest symptom of recovery.
As opposed to brain death, PVS is not recognized as death in any known legal system. This legal grey area has led to several court cases involving people in a PVS state, those who believe that they should be allowed to die, and those who are equally determined that, if recovery is possible, care should continue. Well-known cases include Terri Schiavo, Paul Brophy, and Sunny von Bülow.
Andrews K, Murphy L, Munday R, Littlewood C. Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit.BMJ 1996;313:13-6. PMID 8664760, fulltext (http://bmj.bmjjournals.com/cgi/content/full/313/7048/13).
Persistent Vegetative State (http://www.geocities.com/HotSprings/Oasis/2919/index.html) This source accepts the unawareness of all PVS sufferers and advocates removing life support
"The permanent vegetitative state: ethical crux, medical fiction" (http://www.thalidomide.ca/gwolbring/pvsilm.htm) by Chris Borthwick. The author questions the validity of most PVS diagnoses, and the validity of the basic nosology.
Use of MRI in Prediction of Recovery from Persistent Vegetative State (http://www.transamericareinsurance.com/associate_article.asp?Id=58)
A persistent vegetativestate (PVS) is a condition of patients with severe brain damage in whom coma has progressed to a state of wakefulness without detectable awareness.
Patients in a persistent vegetativestate are usually considered to be unconscious and unaware.
While the term 'persistent vegetativestate' is the most frequent in media usage and legal provisions, it is discouraged by neurologists, who favour the use of the Royal College of Physicians (RCP)(1996) typology which refers only to the vegetativestate, the continuing vegetativestate, and the permanent vegetativestate.
A: A person in a vegetativestate has experienced damage to the brain, and may be described as being unaware of surroundings, outside things or events, usually with periods of "eyes-open." In this state, the person actually wakes and sleeps.
A vegetativestate means that the parts of the brain involved in thinking, speaking, feeling, and interacting with others have died forever, but the part of the brain that keeps the body going, continues to operate.
A: A vegetativestate is called "permanent" or "irreversible" after one month of a vegetativestate caused by an interruption of blood flow to the brain; and after six weeks to six months for vegetativestates caused by head injuries.
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