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High rate of misdiagnosis in patients in an acute vegetative state

Around a quarter of patients in an acute vegetative state when they are first admitted to hospital have a good chance of recovering a significant proportion of their faculties, and up to a half will regain some level of consciousness, researchers from Belgium found out. Another study shows that around 40% of patients were wrongly diagnosed as in a vegetative state, when they in fact registered the awareness levels of minimal consciousness. Comparing past studies on this issue shows that the level of misdiagnosis has not decreased in the last 15 years. These studies should foster debate about appropriate standards of care for these patients, and about end of life limitations, experts said at the European Neurological Society Meeting in Rhodes (Greece).

The profoundly difficult moral and medical issues associated with patients in a vegetative state have been recently highlighted by the case of Terri Schiavo in the United States. Experts disagreed on the right response to her condition. With her eyes wide open, the characteristic that distinguishes the vegetative state from coma, it was clearly impossible for some of her family members to believe she was unconscious. Doctors addressing the 17th Meeting of the European Neurological Society from June 16 to 20 in Rhodes (Greece) stress however that the vegetative state in a significant proportion of patients admitted to intensive care may be transitory, and that there is a wide range of possible recovery scenarios, depending on the type of brain injury. A complementary study shows that assessment by medical teams of a patient's actual state of consciousness continues to be surrounded by confusion and false diagnosis, experts reported at the ENS Meeting.

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