Coma // Current

Deftones bassist reported to be in coma after crash

Deftones bassist Chi Cheng has been hospitalized following a serious car accident, according to a statement from Warner Bros.... more

huffamoose2k
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Trapped inside their bodies, apparently switched off to the world, but still alive: they are the undead. Or so we thought. Forty per cent of patients in a ‘vegetative state’ are misdiagnosed. Now British scientists are leading the field in trying to put that right

Kate Bainbridge is a lively 37-year-old former schoolteacher. We are communicating in the conservatory of her parents’ home in south Cambridge. She has expressive eyes and a broad and ready smile, but she can utter only occasional single words with difficulty. She sits in a wheelchair “speaking” with the aid of a letter-board, using her left forefinger to spell out words individually.

Ten years ago, Kate went into a deep coma and was on a ventilator for several weeks. She had suffered severe brain inflammation after contracting a viral infection. When she came out of the coma, she opened her eyes and could breathe naturally, but she was unresponsive to speech and visual stimuli, and appeared to lack all conscious awareness. She was still in this condition four months after falling ill, and was later diagnosed to be in a persistent vegetative state, or PVS: in other words, persistently unaware. But the diagnosis was wrong.

Although Kate could not speak, or hear properly, or make any kind of signal, or take in sustenance except through a tube into the stomach, she was sometimes aware of herself and her surroundings. She had a raging thirst that was not alleviated by the ward staff. She was racked with pain. Sometimes she’d cry out, but the ward staff thought it was just a reflex action. Kate suffered so much pain and despair that she tried to take her own life by holding her breath.

Then a Cambridge neuroscientist called Dr Adrian Owen put her in a special kind of scanner and performed an unprecedented experiment. It revealed evidence of fluctuating levels of brain activation when she was presented with pictures of her parents. From that point, she started her long journey back into the world. This is a story about brain-impaired patients who come gradually out of coma into “minimal awareness” after being misdiagnosed as being in PVS: breathing, appearing to be wakeful, yet deemed to be dead to themselves and the world. It is also about the disastrous consequences of such misdiagnoses, estimated in the UK and other countries to be running at two in five cases. And, crucially, it is about a neuroscientific research programme that is set to transform the prospects of diagnosis, treatment and rehabilitation of brain-injured people the world over.

Only an estimated 20% of patients return, like the Top Gear presenter Richard Hammond after his car crash in September, to fully functioning normality after serious brain injury. The range of disability following brain damage is hugely varied in type and severity. It is not known how many PVS and minimally conscious patients there are in this country, since no central registry exists. It is likely, according to a canvass of many neurology professionals, to be in the tens of thousands. More certain is the grim reality of hospital wards and long-term care homes where the persistently vegetative and the minimally conscious languish, sometimes for decades.

To write this article I have had the sobering experience of witnessing the plight of patients with severely impaired consciousness – the intubations, the double incontinence, the stricken semicircle of wheelchairs parked before the unwatched day-room TV. And I have met the anguished families of those who are denied final grieving and closure for a loved one condemned to what appears a living death. All too often I have spoken to a wife or husband, or mother or father, who will travel anything up to two hours each way by taxi, every day, to spend time with an unresponsive child or spouse.Trapped inside their bodies, apparently switched off to the world, but still alive: they are the undead. Or so we thought. Forty... more

armchaircritic
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20 days ago

Magnetic field helps coma patient?

"A US patient left in a coma-like state after a road accident recovered the ability to speak after repeated exposure to a magnetic field. Josh Villa had not been expected to recover from massive head injuries.

When "transcranial magnetic stimulation" was aimed at his brain, he could speak simple words, and respond to commands, New Scientist reports. The Chicago-based scientists now plan further research to see if therapy works in other patients.

It is hard for doctors to predict the extent to which brain-damaged patients will recover after falling into a coma, or a "persistent vegetative state". Josh Villa was 26 when he was thrown through the windscreen of his car, and, almost a year later, he was able to open his eyes, but was unresponsive to any kind of external stimulus. Dr Theresa Pape, from the US Department of Veterans Affairs, enrolled him in a six-week study in which an electromagnetic coil was held over the front of his head.

The idea is to stimulate activity in brain cells, in this case, the cells of the "dorsolateral cortex", a part of the brain which sends stimulating messages to other parts of the brain. After approximately 15 sessions, he would turn his head and look at the person talking to him.

Then he started obeying simple commands, such as following the movement of a thumb and finger when asked, and could produce single words, such as "help" or "erm".

After 30 sessions there was no further improvement, and he was sent home to be cared for by his mother. She says that the treatment has made it far easier to look after him.

Dr Pape is now hoping to begin a similar treatment programme in a second patient in a coma-like state. However, another scientist warned that it is possible the magnetic stimulation was not entirely responsible. Dr John Whyte, from the Moss Rehabilitation Research Institute in Philadelphia, said that even eight months after a brain injury, spontaneous improvement of this type was "not uncommon".

He added: "I believe that electromagnetic treatments such as deep brain stimulation, direct current transcranial stimulation, and TMS may all have therapeutic promise. However, proving their efficacy is very challenging because of the confounding and highly variable effects of natural recovery.

"So single cases provide very weak evidence except when treatment occurs very late (so spontaneous recovery should be minimal) and the patient is studied for a considerable interval both before and after the treatment."

TMS has produced promising results when used to treat stroke patients, and those with spinal cord injuries."

Kind of interesting, considering how your brain is filled with ions that in turn create the electrical signals. "A US patient left in a coma-like state after a road accident recovered the ability to speak after repeated exposure to a... more