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Recovery from a state of minimal responsiveness
WILSON, B.A., Gracey, J., Macniven, J., Bainbridge, K
Journal of the International Neuropsychological Society, 10, S1, 124
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We describe a young woman who contracted encephalitis in 1997. She was reported to be in a vegetative state for almost 6 months,. At best she was minimally responsive for 5 months, Even though less than 10% of such patients regain consciousness (and extremely few show significant recovery) we demonstrate here that it is possible to achieve a considerable degree of recovery and emotional adjustment in someone who was unresponsive for several months. During this period of unresponsiveness this woman received a PET scan. This showed that she was able to differentially respond to photographs of her family demonstrating that she could perceive and process visual stimuli. Two years later she was refereed for an assessment of her cognitive functioning., Despite being severely physically handicapped, tube fed, with a tracheotomy tube and communicating with a letter board, her test scores were almost all within the normal range. She was very angry and distressed at her earlier treatment and the loss of so many things in her life. Using a new model of cognitive rehabilitation as a framework we addressed the emotional factors central to her rehabilitation. She changed from being angry and suicidal to recognising her strengths and becoming more involved in life. In conclusion, cognitive assessment showed that this woman was functioning at a much higher level than most of her carers believed. Her anger and distress was treated using a new model of rehabilitation as a framework. So even for people who are in a vegetative/minimally responsive state for several months, a significant degree of cognitive recovery and emotional adjustment is possible.