Medical 23 Years in a Vegetative State or not?

[russ_watters]

23 Years in a Vegetative State...or not?

This story has my B.S.O-Meter smoking:

Belgian car crash victim who was misdiagnosed as being in a vegetative state for 23 years was conscious the whole time, it has emerged.

http://www.cnn.com/2009/HEALTH/11/24/coma.man.belgium/index.html

I am struck by the contradiction of him being in completely paralyzed, "locked-in" state, yet being able to hunt and peck on a keyboard (see the video). At least a decade ago, I saw a 60 minutes piece on "facilitated communication" where a "facilitator" holds the hand of a person in a vegetative state, detects movement and helps type out messages. They were then challenged in blind testing and failed miserably, showing that the the communication was coming entirely from the "facilitators".

If anyone has more details on this particular case, I'd appreciate it. I have no information on exactly how they know he's not in a vegetative state, so, I'm left watching a video of a man who doesn't appear to be looking at a keyboard who is nevertheless hunt-and-peck typing with impressive speed and efficiency.

Here's the wiki on facilitated communication: http://en.wikipedia.org/wiki/Facilitated_communication

 

[Sorry!]

That is insane. I don't really know what to make of it I guess when they scanned his brain the used different stimuli to record activity in his brain and concluded that he was in fact able to hear etc. etc. This facilitated communication seems quite bizarre, I have no idea how they think it works and highly doubt that it even does work all that well. (I did however notice that since yesterday wikipedia has gotten over 300,000$ in donations... that's pretty impressive.)

It's kind of shocking that they claim 41% of people are misdiagnosed when they actually have minimal-conciousness... If that ever happened to me I think I would go crazy.

 

[Monique]

I don't understand that CNN would come with such a poorly carried out interview. I don't know who that woman was and how long she's being typing for that man, but that looks like a scam.

The brain scan appeared to prove that it was still functional, but I don't know to what extent.

 

[mgb_phys]

Mr Randi certainly thinks so.
http://www.randi.org/site/index.php/swift-blog/783-this-cruel-farce-has-to-stop.html

 

[Moonbear]

I'm highly suspicious of the person assisting him with typing. If, as the story says, he's paralyzed, which has limited his ability to communicate, how would he be guiding the typing? That part is likely a complete scam or hoax.

On the issue of "brain scans," without any information on what type of scan or how they were interpreting it, when the last one was done prior, if one was done prior, etc., it's hard to know what to make of it. Technology was VERY different 23 years ago, so I could understand a misdiagnosis being made back then, but it still leaves one wondering why there was no reassessment of the diagnosis in the interim if this is a complete surprise now. So, I guess there is a possibility nobody bothered testing him with modern diagnostics until his mother insisted, but I still don't think that makes it realistic he is communicating through hand/arm movements. They could assess if he has intentional eye movements, since he is able to blink, and his eyes were moving, suggesting at least those nerves are not paralyzed.

But, it's hard to envision how a brain injury that has such a large range of paralysis (it's not just his limbs that are paralyzed...so are a lot of his facial muscles, and he's not swallowing, though is producing saliva...this is quite a spectrum of brain areas being affected, not just a single focal lesion) would leave him with the ability to spell and construct grammatically correct sentences, and even have functional auditory processing to hear and understand the questions.

But, if he's able to see and focus on a keyboard to type, he would have to also have intentional eye movements, so test that. I'd be more convinced that he can communicate if he could select letters on a keyboard by the direction of his focus or blinking patterns than with someone else guiding his hand.

 

[Anwer Pasha]

You can see one Persistent Vegetative State on this profile photo. Sitting on wheel chair.
How he looks?

 

[Anwer Pasha]

sorry it was my first post here.you can see him on my profile

 

[Math Is Hard]

Who is that in your profile picture, Anwer?

 

[Anwer Pasha]

Who is that in your profile picture, Anwer?

It is my PVS son Jawad Pasha. He is is gradually recovering. Sixth year

 

[Math Is Hard]

It is my PVS son Jawad Pasha. He is is gradually recovering. Sixth year

That must be very hard for you. I am glad to hear that he is recovering. What do you do to help him?

 

[Anwer Pasha]

That must be very hard for you. I am glad to hear that he is recovering. What do you do to help him?

Thanks for asking. It is 5 AM in Pakistan and the boy is sleeping with me and I am awaken. This is main clue of our success (may be a little but we are happy) , In morning we put him a car and send him to hospital where a very little physiotherapy is available but yjis journey keeps him moving, He comes back and than we first try to give him a few sips of water by mouth. ( he is feeded by PEG tube) Than after giving him a little rest he crosses through exercises and standing for more than a hour. After that spell he is given a rest and sleeps for a while. When he awakes about 7pm than a family time and a physiotherapy for more than one hour. After that around 10Pm he daily goes for a ride on a car. when comes back than standing and sometimes a little exercise.
Before shifting him to our common bed than we try for some funny exercises and than he sleeps. For knowing more you can try searching about him.

 

[Briant232]

..

But, it's hard to envision how a brain injury that has such a large range of paralysis (it's not just his limbs that are paralyzed...so are a lot of his facial muscles, and he's not swallowing, though is producing saliva...this is quite a spectrum of brain areas being affected, not just a single focal lesion) would leave him with the ability to spell and construct grammatically correct sentences, and even have functional auditory processing to hear and understand the questions.

...

I don't know about this guy, but some people get locked-in syndrome and can only move an eye. Pons lesions usually cause it.

 

[Anwer Pasha]

As I am watching my son and in touch with others. I feel they are not paralyzed. It is some sort of loss of motor function as a result of head trauma . I am in touch with a patient who took only 8 months to reach a stage of consciousness under simple way of personal attention (Accident in last September and he is too without motor function still).
Both my son and the other boy enjoy jokes and funny talks . Natural response through face impressions some time moving their arms and legs ( Not any commanded movements)

 

[Count Iblis]

Recent developments:

http://www.cnn.com/2010/HEALTH/02/04/vegetative.state/index.html?hpt=T2

 

[Anwer Pasha]

Recent developments:

http://www.cnn.com/2010/HEALTH/02/04/vegetative.state/index.html?hpt=T2

Thank you. We are much ahead to this and we have discovered this years before but unfortunately we have not such facilities.

 

[Anwer Pasha]

There was a report that this was a fake report and the assisted therapy didn't work. I am not sure which report is false, First one or this one saying the first report false. Assisted work is possible and I am using and enjoying it when I do exercise of Jawad Pasha (MY Son) and he moves with my assistance and verbal stimulation.
You can read

Pakistan a brain injury Persistent vegetative state patients Jawad Pasha