Evaluation of persistent vegetative state of 34 patients / 中华神经科杂志

ABSTRACT

Objective To investigate an accurate,reliable and objective method to evaluate persistent vegetative state at bedside.Methods The brain function of 34 cases with persistent vegetative state as a result of acute brain injury was evaluated,involving clinical examinations and neuroelectrophysiological evaluations(EEG,BAEP,SLSEP).Results The most common cause of brain damage was anoxic encephalopathy(30/34,88.2%).The patients were in mild,moderate or deep coma with complete or partial existence of brainstem reflection,activities distributed by cerebral nerves,voluntary extremity activities,spinal cord reflection and automatic spinal cord reflection as well as partial existence of pathologic reflection.According to the Young Criteria of EEG,64.5%(20/31)and 29.0%(9/31)of the cases were in grade Ⅰ and Ⅵ respectively,6.5%(2/31)were in grade Ⅲ and Ⅳ.According to the Cant Criteria of evoked potential,34.8%(8/23),21.7%(5/23)and 43.5%(10/23)of the cases were in gradeⅠ,Ⅱ and Ⅲ of brainstem auditory evoked potential,respectively.43.5%(10/23),4.4%(12/23) and 52.2%(12/23)were in grade Ⅰ,Ⅱ and Ⅲ of short-latency somatosensory evoked potential respectively.29.4%(10/34)of 34 cases died,and 11.8%(4/34)resuscitated during 35—90 days. Conclusion Combination of multiple neuroelectrophysiological tests was an accurate,reliable and objective approach to evaluate the brain function of patients with persistent vegetative state,which provides evidence for decision-making in agrypnotic therapy.