Vegetative state: symptoms, causes and treatment

This condition associated with minimally conscious states appears due to brain damage.

We often hear, read, or even use terms whose meaning we are not entirely sure of. By common sense we make arbitrary associations between a state and a term that is not always the one that correctly describes that state. This situation frequently occurs with the vegetative state, which is associated with the vegetative state.which is associated with coma or minimally conscious state. But in reality these three are different, and we should be clear about their differences.

In this article we will learn about the most relevant aspects of the vegetative state, its possible causes and symptoms, as well as the treatments and care that are used to treat it. the treatments and cares that are used for these cases..

What is the vegetative state?

It is determined that the person is in a vegetative state when the brain structures in charge of higher mental functions have ceased to function, but the brain structures in charge of vital functions (sleep cycles, body temperature, respiration and Heart rate) are still functioning.The brain structures in charge of vital functions (sleep cycles, body temperature, respiration and heart rate) are still functioning.

This means that the subject in a vegetative state will have vital signs and will give the impression of being awake, in a state of wakefulness, but will not really respond to any stimulation from the brain. will not respond to any stimulation from the environment, nor will he/she be able to speak, in addition to not being aware of him/herself or others..

This circumstance represents one of the rarest and most infrequent brain pathologies to occur, but when it does occur it is a permanent state. There are treatments that apparently have given results with some patients, causing them to recover brain functions after some time. But it has not been possible to determine whether these patients were really in a vegetative state or only presented a state of minimal consciousness.

Causes

This state occurs when there is some important damage in the upper part of the encephalonmaking it impossible for the individual to have higher mental functions. However, the ascending and descending reticular systems (SARA and SIR) remain functional, taking care of the waking and sleeping states of the subject.

Some of the specific causes that can cause a vegetative state are especially a cranial trauma, a cardiac or respiratory arrest that prevents the arrival of oxygen to the brain. Brain hemorrhages or infections can also trigger a vegetative state in the individual..

Symptoms

Although the brain is affected in terms of its most significant functions, still possesses the capacity for action in certain areas of life, so it may sometimes appear that the person is consciously reacting to the environment.The person may therefore sometimes appear to be consciously reacting to the environment. But in reality these are basic primary reflexes, which have a specific response to certain stimuli.

For example, patients in vegetative state reach out to clench their fist when their palm is touched.. This does not mean that they do it deliberately, it is more like the palmar reflex of infants.

Other symptoms of the vegetative state are as follows: they can open their eyes, they exhibit apparently normal sleep behaviors, but not necessarily related to day and night, they are able to breathe, suck, chew, cough, choke, swallow and make throat sounds.

Although these behaviors may appear to be conscious, they are actually do not respond to any deliberate thought or intention on the part of the patient..

When the cause of the vegetative state has been a head injury rather than a disease that depletes oxygen to the brain, minimal levels of EEG consciousness may be detected. For example, some patients may imagine moving their upper limbs, but are unable to actually do so. As for physiological needs, they are completely involuntary in all cases.

Treatment

For a correct diagnosis it is necessary that the patient has undergone the corresponding medical evaluation, in addition to an MRI scan.in addition to a nuclear magnetic resonance.

Apart from these evaluations, observation must be constant for a significant period of time, to avoid missing some signs of consciousness. Treatment

Taking into account that currently this condition is not reversibleIn this case, care and treatment are preventive in nature, in order to avoid that the subject's physical situation may be affected to a greater extent.

What is done in these cases is to prevent the problems associated with immobilization and to ensure that nutrition is correct.

The physiotherapist and nutritionist usually provide support to the caregivers during the first days of care, They will indicate what the movements should be to help the patient and what the specific diet should be..

Depending on the laws of each country, there are measures regarding the suspension of life support during the vegetative state. This should be discussed by the hospital authorities together with the relatives. In case the patient had left written wishes, these should be taken into account at the time of the final decision.

Bibliographic references:

• Canavero S. (editor) (2009), Textbook of therapeutic cortical stimulation, New York: Nova Science.
• Owen, A. M., Menon, D.K., Johnsrude, I.S., Bor, D. (2002), Detecting residual cognitive function in persistent vegetative state, Neurocase 8 (5): 394-403.