FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 330:1572-1579 June 2, 1994 Number 22 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text Letters Letters Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article by Ashwal, S. Related Article by The Multi-Society Task Force on PVS PubMed Citation

Prognosis for Recovery

There are two dimensions of recovery from a persistent vegetative state: recovery of consciousness and recovery of function. Recovery of consciousness can be verified by reliable evidence of awareness of self and the environment, consistent voluntary behavioral responses to visual and auditory stimuli, and interaction with others. Recovery of function is characterized by communication, the ability to learn and to perform adaptive tasks, mobility, self-care, and participation in recreational or vocational activities. Recovery of consciousness may occur without functional recovery, but functional recovery cannot occur without recovery of consciousness. In some instances, during the early stages of recovery of consciousness, . . . [Full Text of this Article]

Acute Traumatic and Nontraumatic Injuries

Degenerative and Metabolic Diseases

Developmental Malformations

Verified and Unverified Late Recovery

Probability of Recovery

Survival

Pain and Suffering

Treatment

Determining the Level of Treatment

Withdrawing Artificial Nutrition and Hydration

Future Directions

Source Information

This statement has been approved by the American Academy of Neurology, Child Neurology Society, American Neurological Association, American Association of Neurological Surgeons, and American Academy of Pediatrics. The literature search, correspondence, and other documents generated by the task force are available through the American Academy of Neurology in Minneapolis.The members of the task force are Stephen Ashwal, M.D., cochairman (Loma Linda University School of Medicine, Loma Linda, Calif.), Child Neurology Society; Ronald Cranford, M.D., cochairman (Hennepin County Medical Center, Minneapolis), American Academy of Neurology; James L. Bernat, M.D. (Dartmouth Medical School, Hanover, N.H.), American Academy of Neurology; Gastone Celesia, M.D. (Loyola University Stritch School of Medicine, Maywood, Ill.), American Neurological Association; David Coulter, M.D. (Boston University School of Medicine, Boston), Child Neurology Society; Howard Eisenberg, M.D. (Maryland Institute of Emergency Medical Services Systems, Baltimore), American Association of Neurological Surgeons; Edwin Myer, M.D. (Medical College of Virginia, Richmond), American Academy of Pediatrics; Fred Plum, M.D. (New York Hospital-Cornell University Medical College, New York), American Neurological Association; Marion Walker, M.D. (Primary Children's Hospital and Medical Center, Salt Lake City), American Academy of Pediatrics; Clark Watts, M.D. (University of Texas Health Sciences Center, San Antonio), American Association of Neurological Surgeons; and Teresa Rogstad, project coordinator, American Academy of Neurology.

Address reprint requests to the Multi-Society Task Force on PVS, American Academy of Neurology, 2221 University Ave. S.E., Minneapolis, MN 55414.

References

Related Letters:

Withdrawing Treatment in the Persistent Vegetative State
Youngner S. J., O'Toole E., Avila D., Beltran J. E., Goldberg C. K., Angell M.
Extract | Full Text  
N Engl J Med 1994; 331:1382-1383, Nov 17, 1994. Correspondence

Medical Aspects of the Persistent Vegetative State -- A Correction
Ashwal S., Cranford R., The Multi-Society Task Force on PVS
Extract | Full Text  
N Engl J Med 1995; 333:130, Jul 13, 1995. Correspondence

Trans Fatty Acids in Margarine
Taylor S., Michels K. B., Sacks F.
Extract | Full Text  
N Engl J Med 1995; 333:130-132, Jul 13, 1995. Correspondence

This article has been cited by other articles:

• Luther, M. S, Krewer, C., Muller, F., Koenig, E. (2008). Comparison of orthostatic reactions of patients still unconscious within the first three months of brain injury on a tilt table with and without integrated stepping. A prospective, randomized crossover pilot trial. Clin Rehabil 22: 1034-1041 [Abstract]  
• Vanhaudenhuyse, A., Giacino, J., Schnakers, C., Kalmar, K., Smart, C., Bruno, M. -A., Gosseries, O., Moonen, G., Laureys, S. (2008). BLINK TO VISUAL THREAT DOES NOT HERALD CONSCIOUSNESS IN THE VEGETATIVE STATE. Neurology 71: 1374-1375 [Full Text]  
• Racine, E., Amaram, R., Seidler, M., Karczewska, M., Illes, J. (2008). Media coverage of the persistent vegetative state and end-of-life decision-making. Neurology 71: 1027-1032 [Abstract] [Full Text]  
• Fins, J. J., Master, M. G., Gerber, L. M., Giacino, J. T. (2007). The Minimally Conscious State: A Diagnosis in Search of an Epidemiology. Arch Neurol 64: 1400-1405 [Full Text]  
• Truog, R. D. (2007). Brain Death - Too Flawed to Endure, Too Ingrained to Abandon. J Law Med Ethics 35: 273-281  
• Fins, J. J., Schiff, N. D., Foley, K. M. (2007). Late recovery from the minimally conscious state: Ethical and policy implications. Neurology 68: 304-307 [Abstract] [Full Text]  
• Wijdicks, E.F.M., Hijdra, A., Young, G. B., Bassetti, C. L., Wiebe, S. (2006). Practice parameter: prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology.. Neurology 67: 203-210 [Abstract] [Full Text]  
• Fine, R. L. (2006). Ethical Issues in Artificial Nutrition and Hydration. Nutr Clin Pract 21: 118-125 [Abstract] [Full Text]  
• Bernat, J. L. (2006). The Whole-Brain Concept of Death Remains Optimum Public Policy. J Law Med Ethics 34: 35-43  
• Perry, J. E., Churchill, L. R., Kirshner, H. S. (2005). The Terri Schiavo Case: Legal, Ethical, and Medical Perspectives. ANN INTERN MED 143: 744-748 [Abstract] [Full Text]  
• Lavrijsen, J C M, van den Bosch, J S G, Koopmans, R T C M, van Weel, C (2005). Prevalence and characteristics of patients in a vegetative state in Dutch nursing homes. J. Neurol. Neurosurg. Psychiatry 76: 1420-1424 [Abstract] [Full Text]  
• Annas, G. J. (2005). "Culture of Life" Politics at the Bedside -- The Case of Terri Schiavo. NEJM 352: 1710-1715 [Full Text]  
• Maxwell, W. L., Pennington, K., MacKinnon, M. A., Smith, D. H., McIntosh, T. K., Wilson, J. T. L., Graham, D. I. (2004). Differential responses in three thalamic nuclei in moderately disabled, severely disabled and vegetative patients after blunt head injury. Brain 127: 2470-2478 [Abstract] [Full Text]  
• Fischer, C., Luaute, J., Adeleine, P., Morlet, D. (2004). Predictive value of sensory and cognitive evoked potentials for awakening from coma. Neurology 63: 669-673 [Abstract] [Full Text]  
• Ravelingien, A, Mortier, F, Mortier, E, Kerremans, I, Braeckman, J (2004). Proceeding with clinical trials of animal to human organ transplantation: a way out of the dilemma. J. Med. Ethics 30: 92-98 [Abstract] [Full Text]  
• Gladsjo, J. A., Breding, J., Sine, D., Wells, R., Kalemkiarian, S., Oak, J., Vieira, A. S., Fallo Friedlander, S. (2004). Termination of Life Support After Severe Child Abuse: The Role of a Guardian ad Litem. Pediatrics 113: e141-145 [Abstract] [Full Text]  
• Geluing, L. (2004). Researching patients in the vegetative state: Difficulties of studying this patient group. Journal of Research in Nursing 9: 7-17 [Abstract]  
• Matsuda, W, Matsumura, A, Komatsu, Y, Yanaka, K, Nose, T (2003). Awakenings from persistent vegetative state: report of three cases with parkinsonism and brain stem lesions on MRI. J. Neurol. Neurosurg. Psychiatry 74: 1571-1573 [Abstract] [Full Text]  
• Greenwood, R. (2002). HEAD INJURY FOR NEUROLOGISTS. J. Neurol. Neurosurg. Psychiatry 73: i8-16 [Full Text]  
• Lombardi, F., Taricco, M., De Tanti, A., Telaro, E., Liberati, A. (2002). Sensory stimulation of brain-injured individuals in coma or vegetative state: results of a Cochrane systematic review. Clin Rehabil 16: 464-472 [Abstract]  
• Bates, D. (2001). THE PROGNOSIS OF MEDICAL COMA. J. Neurol. Neurosurg. Psychiatry 71: i20-i23 [Full Text]  
• Zeman, A. (2001). Consciousness. Brain 124: 1263-1289 [Abstract] [Full Text]  
• Mazeika, P (2001). Aborted sudden cardiac death: a clinical perspective. Postgrad. Med. J. 77: 363-370 [Abstract] [Full Text]  
• Jennett, B., Adams, J. H., Murray, L. S., Graham, D. I. (2001). Neuropathology in vegetative and severely disabled patients after head injury. Neurology 56: 486-490 [Abstract] [Full Text]  
• Wade, D. T (2001). Ethical issues in diagnosis and management of patients in the permanent vegetative state. BMJ 322: 352-354 [Full Text]  
• Crispi, F, Crisci, C (2000). Patients in persistent vegetative state... and what of their relatives?. Nurs Ethics 7: 533-535  
• Ayorinde, B. T., Scudamore, I., Buggy, D. J. (2000). Anaesthetic management of a pregnant patient in a persistent vegetative state. Br J Anaesth 85: 479-481 [Abstract] [Full Text]  
• Adams, J. H., Graham, D. I., Jennett, B. (2000). The neuropathology of the vegetative state after an acute brain insult. Brain 123: 1327-1338 [Abstract] [Full Text]  
• Wade, D. T, Johnston, C. (1999). The permanent vegetative state: practical guidance on diagnosis and management. BMJ 319: 841-844 [Full Text]  
• ANDREWS, K. (1999). The vegetative state - clinical diagnosis. Postgrad. Med. J. 75: 321-324 [Full Text]  
• Brody, H., Campbell, M. L., Faber-Langendoen, K., Ogle, K. S. (1997). Withdrawing Intensive Life-Sustaining Treatment -- Recommendations for Compassionate Clinical Management. NEJM 336: 652-657 [Full Text]  
• Cranford, R. (1996). Misdiagnosing the persistent vegetative state. BMJ 313: 5-6 [Full Text]  
• Schwaber, E. A., Caplan, L., Childs, N. L., Mercer, W. N. (1996). Late Improvement after Post-Traumatic Vegetative State. NEJM 334: 1201-1202 [Full Text]  
• Childs, N. L., Mercer, W. N. (1996). Late Improvement in Consciousness after Post-Traumatic Vegetative State. NEJM 334: 24-25 [Full Text]  
• Ashwal, S., Cranford, R., The Multi-Society Task Force on PVS, (1995). Medical Aspects of the Persistent Vegetative State -- A Correction. NEJM 333: 130-130 [Full Text]  
• Andrews, K. (1995). Report is unnecessarily negative. BMJ 310: 1137a-1137 [Full Text]  
• Nelson, L. J., Ruston, C. H., Cranford, R. E., Nelson, R. M., Glover, J. J., Truog, R. D. (1995). Forgoing Medically Provided Nutrition and Hydration in Pediatric Patients. J Law Med Ethics 23: 33-46  
• Howard, R. S, Miller, D. H (1995). The persistent vegetative state. BMJ 310: 341-342 [Full Text]  
• Youngner, S. J., O'Toole, E., Avila, D., Beltran, J. E., Goldberg, C. K., Angell, M. (1994). Withdrawing Treatment in the Persistent Vegetative State. NEJM 331: 1382-1383 [Full Text]