Conscious While Being Considered in an Unresponsive Wakefulness Syndrome for 20 Years
Audrey Vanhaudenhuyse, Vanessa Charland-Verville, Aurore Thibaut, Camille Chatelle, Jean-Flory L. Tshibanda, Audrey Maudoux, Marie-Elisabeth Faymonville, Steven Laureys, Olivia Gosseries
Frontiers in Neurology August 28, 2018 DOI: 10.3389/fneur.2018.00671 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | Severely brain-damaged patient |
| Keywords | Disorders of consciousness Misdiagnosis Locked-in syndrome Unresponsive wakefulness syndrome MRI PET |
| Key findings | A patient considered in a vegetative state for 20 years was actually fully conscious and able to communicate, leading to a revised diagnosis of incomplete locked-in syndrome. |
Abstract
Despite recent advances in our understanding of consciousness disorders, accurate diagnosis of severely brain-damaged patients is still a major clinical challenge. We here present the case of a patient who was considered in an unresponsive wakefulness syndrome/vegetative state for 20 years. Repeated standardized behavioral examinations combined to neuroimaging assessments allowed us to show that this patient was in fact fully conscious and was able to functionally communicate. We thus revised the diagnosis into an incomplete locked-in syndrome, notably because the main brain lesion was located in the brainstem. Clinical examinations of severe brain injured patients suffering from serious motor impairment should systematically include repeated standardized behavioral assessments and, when possible, neuroimaging evaluations encompassing magnetic resonance imaging and 18F-fluorodeoxyglucose positron emission tomography.