Sunday, August 28, 2005

Review of states of prolonged impaired consciousness

August's Mayo Clinical Proceedings has a review, coauthored by Dr. Ron Cranford, of prolonged states of impaired consciousness in adults.   It covers the PVS, MCS, as well as akinetic mutism and brain death.  It is a somewhat casual & mostly descriptive piece & quite an interesting read.  What was most interesting to me was a lengthy description of the range of range of clinical findings in the PVS (varieties of eye & bodily movements, startle responses etc.)  Not surprisingly, it concludes with some words about the Schiavo case, including a jab at Dr. William Hammesfar (the Schindler's expert neurologist)--although not by name--& this nugget:

      Unprecedented in this case was a major focus on distinguishing a permanent vegetative state from an MCS. Far more surprising, being in an MCS was considered by some an opportunity for therapeutic intervention and the approach to take despite Schiavo's unchanged catastrophic neurologic state for 15 years.

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