Persistent vegetative state is a condition of severe unconsciousness, a vegetative state for more than one month. It may be caused by head injuries such as traumatic brain injury. The upper area of the brain that is responsible for movement, sensory perception, speech and cognitive functions (i.e. thinking, memory and judgment) is the one affected. Other causes include non-traumatic events such as infections of the nervous system, stroke, cardiac arrest and metabolic changes of the body.

A patient in a persistent vegetative state is therefore unable to move, but is not considered brain-dead. He is very much alive but is unable respond to the environment, including any stimulation such as pain, light, voices or other sounds. Patients have no control over bowel movement and urination. However, patient still has non-cognitive functions such as breathing, circulation and a sleep-wake cycle. Eyes are open but he is unable to speak. There are some instances when patients may smile, grind teeth or make minor facial movements.

Prognosis

Prognosis varies mainly from patient to patient. The longer the patient stays in a vegetative state, the lesser are the chances of recovery. A patient may regain wakefulness but there is no longer higher brain function other than basic reflexes. However, if persistent vegetative state continues for more than a year, then the condition is considered permanent.

Care Plan

The care plan is mainly supportive. Thus, special care and attention is needed in order to assist loved ones in daily living. Frequent bathing is needed to keep them clean since patients in a prolonged condition are prone to infections. It is important to keep your loved one in the best state of health to ward-off potentially lethal infections such as pneumonia.

Also, prolonged confinement in bed increases the risk for your loved ones to develop pressure ulcers or commonly called bed sores. These are injuries to tissues due to pressure and reduced blood flow over long periods of time and commonly affect bony areas such as shoulders, elbows, ankles and knees. Therefore, it is important that your loved ones be frequently turned and repositioned to relieve accumulating pressure and to even the distribution of weight. Also maintain good skin care by making sure their skin is clean and dry. This is also to prevent infection.

Emerging from persistent vegetative state may be gradual. Some make it to full recovery. Physical therapy and speech therapy may be recommended. Stimulation through voices and music may also be beneficial. Consult with your doctor and dietician about the appropriate diet plan for your loved one while in this critical state.

There are some cases of persistent vegetative state wherein the damage to the brain is so severe that movements, sensory perception and cognitive functions (e.g. memory and judgment) are no longer possible. If, after a year, the condition fails to improve, doctors may assess and declare the condition to be irreversible. Withdrawal of treatment may be suggested, if prolonging the condition is no longer in the best interest of the patient.