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VEGETATIVE STATE

Neurology

VEGETATIVE STATE

1. Vegetative state results from severe bilateral cerebral dysfunction, often following a period of coma.

2. Caused by anoxic brain damage (e.g., after Ml) and may be the terminal phase of degenerative processes such as Alzheimer & CJD.

3. These patients typically have normal sleep-wake cycles but no discernible cognitive function.

4. Respiration can quicken in response to stimulation, and there may be automatisms such as swallowing, bruxism, grimacing, grunting, and moaning. There is loss of sphincter control.

5. EEG abnormalities include low-amplitude delta-frequency background activity, burst suppression, widespread alpha and theta activity, an alpha coma pattern, and sleep spindles. Stimulating the patient causes minimal if any change in background EEG activity.

6. Vegetative state that persists more than 3 months is called persistent vegetative state. Patients who do not recover after 3 months are unlikely to recover.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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