Affiliations: Professor of Neurology and Pediatrics, David Geffen School of Medicine at UCLA, Chief, Department of Neurology, Olive View-UCLA Medical Center, 14445 Olive View Drive, Sylmar, CA 91342-1495, USA. Tel.: +1 818 364 3104; Fax: +1 818 364 3286; E-mail: ashewmon@mednet.ucla.edu | [x] Department of Neurosciences, Ospedale “Santa Maria della Misericordia”, Udine, Italy | [y] Concussion Care Center of Virginia, Inc., Ltd., Tree of Life Services, Inc., Pinnacle Rehabilitation, Inc., Glen Allen, VA, USA
Abstract: Neurophysiological research on the vegetative state (VS) presupposes a clearly defined patient population. VS has been variously defined in three domains: anatomy, behavior, and consciousness. Research on each conceptual type of “VS” is reviewed. Certain key elements of official VS dogma are cast into doubt or flatly contradicted by recent noninvasive neurophysiological studies. “Behavioral VS” is often the manifestation of a multi-modular disconnection syndrome rather than the complete absence of cortical functioning. Some “behavioral VS” may represent a “super locked-in state,” with some primitive awareness of self and environment, including the capacity to experience pain. The term VS should be dropped and replaced with one that reflects what is truly known and verifiable about the condition and the individual patient.
