Medical Aspects of the Persistent Vegetative State

Abstract

There are two dimensions of recovery from a persistent vegetative state: recovery of consciousness and recovery of function. Recovery of consciousness can be verified by reliable evidence of awareness of self and the environment, consistent voluntary behavioral responses to visual and auditory stimuli, and interaction with others. Recovery of function is characterized by communication, the ability to learn and to perform adaptive tasks, mobility, self-care, and participation in recreational or vocational activities. Recovery of consciousness may occur without functional recovery, but functional recovery cannot occur without recovery of consciousness. In some instances, during the early stages of recovery of consciousness, external manifestations may not be immediately apparent. Repeated examinations over time are necessary to ensure the consistency and accuracy of signs of recovery.