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"Plant state", "non-responsive awakening", "minimum state of consciousness"

Updated: May 29, 2022

Studying the "Study of Consciousness" (Stanislas Duanne) can further deepen your understanding of coaching theory.

I am studying to add a unique flavour to "unconscious rewriting".


This series of blog posts are my study notes. This time, the theme that follows the unconscious and conscious

I will write a "sign of consciousness".


 

Patients in a vegetative state wake up every day, but even when they wake up, they do not respond and seem to be completely unaware of their surroundings.


The state in which the sleep/wake cycle is maintained without any sign of consciousness is the most characteristic of the vegetative state and is known as "non-responsive awakening".


This situation can last for years. However, patients will not die if they continue to breathe spontaneously and be artificially nourished.


There is an example of a controversy over the dignified death of an American woman named Teri Sybo. She lived in a vegetative state for 15 years and developed into a political-judicial conflict involving the central political world. She died in 2005 when she was ordered to remove the feeding tube.


The word "vegetative" is reminiscent of the helpless "vegetable," but sadly, the nickname is well-established inwards where patients are treated poorly.



It was coined from the verb vegetate, which means "to live a mere physical life without intellectual activity or social interaction."

Autonomic nervous system-dependent functions such as heart rate, vascular tone, and temperature regulation are generally intact.



The patient is not entirely immobile and sometimes shows slow but precise movements depending on the body and eyes.

Suddenly you smile, cry, or frown.


Such movements can also cause great confusion in the patient's family (in the case of Teri Shybo, it still thought her parents could help her).


But neurologists believe that reflexes can cause such physical reactions. The spinal cord and brainstem can produce involuntary movements with no specific purpose.

Patients never respond to the voices of others, making meaningless growls but never speaking.


Doctors will diagnose a "persistent vegetative state" one month after the patient's first injury and three months, depending on whether the injury is due to oxygen deficiency or head trauma. Twelve months after that, a diagnosis of "permanent vegetative state" will be made.


However, there is much debate about whether these terms are appropriate.


This state is because the unconscious state persists, implying that recovery is impossible.


In some cases, a decision may be made to prematurely remove the life support system.


Some clinicians and researchers use the neutral term "non-responsive arousal."

This phrase puts a hold on judgments about the patient's condition now and in the future.



The vegetative state is a general term for various states that are not so accurately understood, including rare cases such as consciousness but lack of communication ability.


The term "minimum state of consciousness" has been used since 2005.

Patients with severe brain damage can experience significant fluctuations in their state of consciousness, even for just a few hours, and sometimes exhibit some degree of spontaneously controlled behaviour. Patients placed in this state are classified as "minimum state of consciousness."


Patients in the least conscious state sometimes blink to react to the words of others or to follow the mirror with their eyes.

This patient can answer "yes" or "no" aloud or nod.


Also, patients in the least conscious state may express emotions appropriate to the situation, unlike patients in the vegetative state who suddenly smile or cry.

A single hint is not enough to make a definitive diagnosis, and signs of consciousness need to be observed with some consistency.


Patients with minimal consciousness are generally placed in a state where they cannot consistently express their thoughts.

Their behaviour is highly variable. There are no signs of consistent consciousness; on other days, it is seen in the morning and not in the evening.

In addition, the judgment that the patient laughed or cried must be highly subjective.


Statistically, patients diagnosed with minimal consciousness are more likely to regain stable consciousness than patients who have been in a vegetative state for many years.


Recovery usually follows a very gradual course, and over weeks, the patient's response gradually stabilizes and becomes consistent.


The patient may suddenly wake up within a few days in rare cases. By regaining the ability to communicate with others, the patient is out of minimal consciousness.


The "minimum state of consciousness" differs from the "locked-in syndrome" experienced by Jean-Dominique Bobby.

Locked-in syndrome usually results from damage to a confined area, generally the pars tuberalis of the brainstem.


Such injuries cut the corticospinal tract with extreme accuracy. However, the cortex and thalamus are not damaged, so consciousness often remains.


When the patient wakes up from a coma, he is trapped in a paralyzed body, unable to speak or move.


Although the eyes are stationary, only slight vertical movements and blinks through other neural pathways are generally possible, thereby communicating with the outside world.


Unlike comatose, vegetative, and minimally conscious patients, syndromed patients are not impaired in consciousness. Some even maintain an uplifting mood.


According to a recent study measuring their mental quality of life, the majority report happiness comparable to the average level of healthy individuals once the first few months of horrific discomfort have passed.

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