Presentation
We present examples showing the importance of 3D anatomic reconstruction of brain structures and MRI tractography for assessing white matter connectivity. [ncbi.nlm.nih.gov]
The data presented indicate that the level of arousal in patients in the PVS can be adequately monitored by measuring SCR, HR and EMG parameters. Actions (login required) View Item [eprints.bice.rm.cnr.it]
Entire Body System
- Fatigue
It is also important to avoid the risk of overstimulation as this may result in rapid breathing, tightening of the muscles, grinding of the teeth, restlessness and fatigue. [brainline.org]
The situation is complicated by the uncontested existence of a number of factors - medication cycles, fatigue, differing levels of arousal, muscle wasting - that might induce inconsistency of response in conscious patients. [web.archive.org]
- Malnutrition
Such patients also do not manifest the characteristic signs of malnutrition after depletion of nutrients over a prolonged period. [dx.doi.org]
Respiratoric
- Aspiration
Good skin care, passive joint exercises to minimise contractures, suction where necessary to help avoid aspiration, careful management of the incontinent bladder and bowel, and attention to oral and dental hygiene are all required. [patient.info]
A tracheostomy may be required to maintain airway patency and prevent aspiration pneumonia. Bladder and bowel care is desirable for hygienic reasons. [dx.doi.org]
Psychiatrical
- Abnormal Behavior
Such patients have limited communication skills and abnormal behavioral and emotional responses. They are partially or totally dependent on assistance from others in performing the activities of daily living. [dx.doi.org]
There has not been a systematic attempt to integrate these phenomena to provide better understanding of how the abnormal behaviors of a particular psychiatric patient might be related to the specific pattern of the deviant electrical activity, nor just [aetna.com]
Neurologic
- Agitation
Patients completed a total of 4–8 blocks depending on their degree of agitation, and controls each completed 6 blocks. [medscape.com]
The 17 misdiagnosed patients ranged (table 1 ) in cognitive ability from level 5 (confused, inappropriate, non-agitated) to level 8 (purposeful-appropriate) on the Rancho scale 9 ; in other words, from aware but severely cognitively impaired to nearly [bmj.bmjjournals.com]
Honored guest presentation: abulia minor vs. agitated behavior. Clin Neurosurg 1983 ; 31 : 9 –31. Giacino JT, Ashwal, S, Childs, N, Cranford, R, Jennett, B, Katz, DI, et al. The minimally conscious state: definition and diagnostic criteria. [dx.doi.org]
- Myoclonus
Outcome from coma after car-diopulmonary resuscitation: relation to seizures and myoclonus. Neurology 1988 ; 38 : 401 – 405. 41. Gaches, J. Activites periodiques en E.E.G. Rev EEG Neurophysiol 1971 ; 1 : 9 – 33. 42. [cambridge.org]
Generalized startle myoclonus, failure to condition to eyebrow tapping and no focal responses to noxious stimuli. Sustained flexor posture in all four limbs accentuated by local stimulation. [dx.doi.org]
Some patients have acquired, nonhabitual startle myoclonus. Such activities are inconsistent, nonpurposeful, and coordinated only when they are expressed as part of a subcortical, instinctively patterned, reflexive response to external stimulation. [doi.org]
- Alteration of Consciousness
In recognition that some patients with severe alterations in consciousness can, nonetheless, demonstrate discernible and reproducible but intermittent behavioral evidence of consciousness, a committee, the Aspen Neurobehavioral Conference Workgroup, proposed [medlink.com]
The degree of alteration of consciousness depends on how much and which region of the cortex is deafferentated ( 13 ). [tidsskriftet.no]
This explanation could prevail in Patient VS4, where the altered state of consciousness was caused by a focal pontine haemorrhage, and in which behavioural sleep-wake cycles were also relatively deficient. [academic.oup.com]
Workup
The SBU assessment stated: "[t]here is limited evidence that either visually rated EEG or qEEG helps the diagnostic workup differentiate AD (Alzheimer’s Disease) patients from controls or AD from other dementia disorders." [aetna.com]
EEG
- Generalized Periodic Patterns
EEG findings included normal, continuous generalized slowing, intermittent generalized slowing, background slowing, background suppression, alpha, generalized periodic pattern, PLEDS, and triphasic waves. [ncbi.nlm.nih.gov]
EEG findings included normal, continuous generalized slowing, intermittent generalized slowing, background slowing, background suppression, alpha, generalized periodic pattern, PLEDS… CONTINUE READING [semanticscholar.org]
- Triphasic Waves
EEG findings included normal, continuous generalized slowing, intermittent generalized slowing, background slowing, background suppression, alpha, generalized periodic pattern, PLEDS, and triphasic waves. [ncbi.nlm.nih.gov]
This may cause epileptiform changes, varying in type and extent, such as spiked triphasic waves or periodic or persistent epileptic activity ( 24 ). [tidsskriftet.no]
- Abnormal EEG
[…] to detect this, and the EEG only became abnormal in IPD at clinical onset. [aetna.com]
Treatment
These were conducted at baseline and after completion of the treatments. 3 children were enrolled. The Rancho assessment scales showed no change with treatment. [ncbi.nlm.nih.gov]
Two months after the start of the treatment, he was extubated and was able to say his name and address correctly. Six months after the start of treatment, he was transferred to another hospital to continue rehabilitation. [dx.doi.org]
Prognosis
Conflicting perspectives about the diagnosis and prognosis of the persistent vegetative state (PVS) as well as end-of-life (EOL) decision-making were disseminated in the Terri Schiavo case. [ncbi.nlm.nih.gov]
As therapies aimed at cerebral resuscitation and preservation following acute injury are developed and proved efficacious, prior guidelines for determining prognosis will require redefinition and reconfirmation. [accessmedicine.mhmedical.com]
Table 5 Clinical signs and prognosis No single clinical sign is significant as an indicator of poor prognosis in individual patients, but a combination of clinical signs may potentially improve the accuracy of prognosis; this has been analysed by Levy [jnnp.bmj.com]
Etiology
Median survival based on etiology varied from 3.0 to 8.6 years; no consistent relationship existed between etiology and duration of survival. [ncbi.nlm.nih.gov]
Traumatic brain injury and diffuse cerebral hypoxia are the most common etiologies. Patients in PVS may appear awake but are not aware or conscious, and they are unable to communicate with others or purposefully interact with their environment. [amboss.com]
Epidemiology
Persistent vegetative state after severe brain damage was studied epidemiologically in 110 cases from 1973 to 1976. The causes of brain damage were varied. [ncbi.nlm.nih.gov]
The epidemiology of pediatric head injuries: Data from a referral centre in Victoria, Australia. J Paediatr Child Health. 2009; May 28; 10 Egan J, Snyman N, Scheinberg N. et al. [doi.org]
[…] produced and regulated. [ 9 ] It is also important to determine whether patients in PDOC experience pain, and functional imaging may also be of help in this area. [ 10 ] There is consideration for the role of post-mortems in confirming the diagnosis - for epidemiological [patient.info]
Pathophysiology
To clarify the pathophysiological differences of the cerebrovascular reserve capacity in relation to cerebral cognitive impairments between persistent vegetative state (PVS) and vascular dementia (VD), we evaluated acetazolamide (ACZ) vasoreactivity testing [ncbi.nlm.nih.gov]
[…] brain injury Diffuse cerebral hypoxia Other causes of severe damage to the cerebral hemispheres and/or thalamus (e.g., neurodegenerative diseases, CNS infections, metabolic disturbances, toxins, developmental malformations of the CNS ) References: [1] Pathophysiology [amboss.com]
[…] and fractional anisotropy are related to the density, diameter and geometry of myelinated fibers.[10,23] We are using this technique to assess anatomical connectivity in PVS and MCS patients.[11] This is crucial for explaining and understanding the pathophysiology [medicc.org]
In the present article we seek to provide a principle understanding of electroencephalography (EEG), with an outline of the basic physiology and some simple pathophysiological observations. [tidsskriftet.no]
Prevention
Much of this research focuses on finding better ways to prevent and treat coma. [web.archive.org]
Heterogeneity of brain injury, consequences of long term minimal brain activity and potential factors that prevent recovery to consciousness are discussed. [ncbi.nlm.nih.gov]
Preventing blood clots includes use of drugs and compression or elevation of the person's legs. Moving the limbs, as occurs in passive-range-of-motion exercises, may also help prevent blood clots. [msdmanuals.com]