A vegetative state is a disorder of consciousness or an altered consciousness. It is caused by severe brain damage. Someone in a persistent vegetative state may look like they’re awake, but they don’t have an awareness of their surroundings.
What Causes a Vegetative State?
A vegetative state is the result of significant damage to parts of the brain. The cerebrum is the area of the brain responsible for consciousness. If that area gets damaged, a person can lose the capacity for consciousness.
The reticular activating system is the part of the brain that controls wakefulness. It’s part of the brain stem, which controls automatic bodily functions like the heart, lungs, digestion, and immune system. If this area isn’t damaged, the person’s body will function physically and seem awake despite the lack of consciousness.
What Are the Symptoms of a Vegetative State?
The main symptom of a vegetative state is a lack of consciousness. People in this state don’t show the usual signs of consciousness, such as being able to speak, respond to commands, move with purpose, or avoid painful stimuli.
A person in a vegetative state, however, has many normal physical functions, including heartbeat and breathing. They sleep and wake up in typical patterns. They may chew and swallow food. They may make sounds, though they don’t use language. They keep their eyes open when they are awake. They may have a functional startle reflex and react to sudden stimuli around them.
In order to check if there is any brain response to commands or questions, doctors may do imaging tests. Some tests, such as a PET scan, look for treatable disorders that are causing the lack of consciousness. Doctors may also do a functional MRI.
If symptoms don’t change after a month, the diagnosis is a persistent vegetative state.
Is There Treatment for a Vegetative State?
Once doctors have determined that there is no way to reverse the brain trauma, treatment involves caring for the person’s physical needs. People can live in a vegetative state for years if they get appropriate care. This may mean having home health workers help care for them, or they may need to be in a nursing facility.
People in a vegetative state need assistance with activities such as eating, bathing, and getting in and out of bed. They may need to be put on a feeding tube. Their caregivers will need to pay attention to their skin to avoid pressure sores from being in the same position in a bed or in a wheelchair for too long.
Respiratory infections and urinary tract infections are significant risks for people in a vegetative state. Blood clots can also be a problem due to their lack of mobility. Caregivers need to be trained to be alert to these possible health issues.
Can a Person Recover from a Vegetative State?
Some people recover from a vegetative state, but it is usually not a complete recovery. The brain damage will likely result in permanent disabilities.
Recovery is most likely if the cause of the vegetative state is an injury or a reversible condition such as low blood sugar or a drug overdose. If brain damage is due to lack of oxygen after a stroke or cardiac arrest, recovery is much less common.
It is very rare for someone to recover if the vegetative state lasts more than a month. Occasionally, people with head injuries have some recovery within 12 months, though they tend to have lasting effects from their injuries.
Is a Vegetative State the Same as a Coma?
A vegetative state is sometimes confused with other altered consciousness states, particularly comas. People in a coma are also unresponsive but do not show any signs of wakefulness. They remain motionless, with their eyes closed. They look as if they are asleep.
There is also a condition called a minimally conscious state. People in this condition may have periods of being able to respond to stimuli, such as questions or commands. They have the ability to make purposeful motions. Some people go into a minimally conscious state as part of recovery from a coma or vegetative state. For others, minimal consciousness is a permanent effect of a brain injury.
A vegetative state is not the same as brain death. A person who is brain dead has no brain function at all. If they are on life support machines, their heart will stop as that support is taken away.