Diagnosis - Brain Function / Coma / Persistant Vegetative State / Locked In Syndrome / Awakenings

40% of PVS Patients Misdiagnosed, Half Recover: Two Articles (2007)

An international study finds that about forty percent of patients like Terri Schiavo who are supposedly in a persistent vegetative state are misdiagnosed and another fifty percent of them recover from their situation.

The study finds the patients in question were in a minimally conscious state and could improve.

The studies, conducted by researchers in Belgium, found that the level of misdiagnosis has not decreased in the last 15 years. The findings were presented at the European Neurological Society Meeting in Greece.

Dr. Steven Laureys, from the Coma Science Group at the University of Li?ge, stressed during the meeting that the vegetative state in a significant proportion of patients admitted to intensive care may be transitory. “The study underlines the importance of extreme caution in any decision to limit the life chances of patients during the acute phase of a vegetative state,” he said.

Laureys and his team studied whether the so-called PVS state is a long-term proposition for patients and he analyzed data collected over a five year period at the 26 bed intensive care unit at the university hospital. He and his colleagues examined 5900 patients and found that just over half of those who showed some degree of impaired consciousness on admission were diagnosed as in a vegetative state. Of these patients with serious brain damage, 28% died in the intensive care unit. 15% were classified as still in a vegetative state when they left intensive care.

However, just over half of those who had originally been considered to be in a vegetative state left the unit having recovered consciousness to some degree.

The largest group, 59 percent of those who recovered, got to the point that they could obey commands and instructions from doctors and family.

Laureys: “It is an extraordinarily difficult experience for any family to be confronted with a member suffering acute brain injury, alive but with their faculties so damaged that they may seem beyond awareness. The data emerging from this study clearly demonstrate however that 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.”

Meanwhile, the research team found that around 40% of patients were wrongly diagnosed as in a vegetative state, when they in fact registered the awareness levels of minimal consciousness. In those patients health workers had diagnosed as in a minimally conscious state, 10% were actually communicating functionally. Laureys said younger patients usually having a better prognosis. [21June07, Ertelt, LifeNews.com, Rhodes, Greece]



PERMANENT VEGETATIVE STATE (PVS) DIAGNOSIS OFTEN INACCURATE MORE DATA SHOWS By Hilary White RHODES, June 21, 2007 (LifeSiteNews.com) – News-Medical.net is reporting on a series of studies that show a high rate of misdiagnosis and inaccuracy in patients deemed to be in a “permanent vegetative state” (PVS).

The researchers say that the problem is grounds for “extreme caution” in decisions that might “limit the life chances” of patients. The pretext of a PVS diagnosis is commonly put forward by the euthanasia movement as a reason to allow euthanasia by dehydration, as in the case of Terri Schiavo.

Researchers at the University of Liège in Belgium examined data on over 5900 patients at the intensive care unit at the university hospital. The data showed that of 356 patients diagnosed on admission as being in a vegetative state, just over half left the hospital with some degree of restored consciousness. 59% had recovered enough to obey commands.

The Belgian study said that a quarter of such patients have a good chance of recovery of a “significant proportion of their faculties”. Another showed that as many as 40% of PVS diagnosed patients were incorrectly diagnosed as having no cognitive function when in fact they had minimum consciousness.

Experts at the June 16 to 20 European Neurological Society Meeting in Rhodes said the findings showed that greater care had to be exercised with regard to end-of-life decisions. These findings match many other studies that show the PVS diagnosis is frequently inaccurate. As long ago as 1996, a study published in British Medical Journal showed that 43% of patients diagnosed with PVS do not qualify for the diagnosis.

Dr. Steven Laureys, the lead researcher in the Belgian study, said, “Our data shows that acute vegetative state is certainly not rare among patients admitted to intensive care.”

“What is important to note is that it may be transient and that the prognosis for patients with impaired consciousness depends to a great extent on the nature of the brain damage.”

The transitory nature of the PVS condition is attested by regular news features about patients that doctors had declared incurable ‘waking’ after significant time in a coma or reduced state of consciousness.

Legal expert and anti-euthanasia activist Wesley J. Smith writes that the research “should give great pause to those who advocate not supplying or quickly removing life support for people with traumatic head injury.”

Smith suggested that it should also prevent doctors from dismissing the assertions of family members that a patient has some consciousness. In their fight to save their daughter’s life, the family of Terri Schindler-Schiavo were persistently told by doctors that they were only imagining their daughter’s reactions to stimuli.

Smith writes, “What really needs to be done is to reject the notion that people with severe brain injuries are somehow less ‘human’ or are not ‘persons.’ Unless and until we do that, people in these devastated states will not be safe.”

Read related LifeSiteNews.com coverage:

Boy in “Hopeless” Vegetative State Awakens and Steadily Improves http://www.lifesite.net/ldn/2006/oct/06101001.html

Diagnosis of Persistent Vegetative State Questioned as Former Patient Speaks Out http://www.lifesite.net/ldn/2003/nov/03111207.html