Long-term outcomes of chronic minimally conscious and vegetative states.

Abstract:

OBJECTIVE:The present retrospective cohort study compares the long-term functional outcome, improvement or deterioration, of patients considered in a vegetative state (VS) or a minimally conscious state (MCS) 1 year after coma onset, then yearly for up to 5 years. METHODS:We reviewed the clinical courses of 12 patients in VS and 39 in MCS. The outcomes were assessed at 2, 3, 4, and 5 years after injury using the 5 categories of the Glasgow Outcome Scale plus an additional category for patients in MCS. A logistic regression analysis investigated the relationships between each outcome and 10 predictor variables. Four of these variables were auditory evoked potentials recorded at the early stage of coma. RESULTS:None of the patients in VS improved during the follow-up period: 1 was lost to follow-up, 9 died, and 2 remained in VS. Among patients in MCS, 3 were lost to follow-up, 14 died, 9 remained in MCS, and 13 emerged from MCS with severe disabilities. VS, age >39 years, and bilateral absence of cortical components of middle-latency auditory evoked potentials were significantly associated with deterioration. CONCLUSIONS:In contrast to patients in VS, a third of patients in MCS improved more than 1 year after coma onset. This emphasizes the need to define reliable boundaries between VS and MCS using repeated clinical evaluations and all imaging and neurophysiologic tools available today.

journal_name

Neurology

journal_title

Neurology

authors

Luauté J,Maucort-Boulch D,Tell L,Quelard F,Sarraf T,Iwaz J,Boisson D,Fischer C

doi

10.1212/WNL.0b013e3181e8e8df

subject

Has Abstract

pub_date

2010-07-20 00:00:00

pages

246-52

issue

3

eissn

0028-3878

issn

1526-632X

pii

WNL.0b013e3181e8e8df

journal_volume

75

pub_type

杂志文章
  • Intrinsic epileptogenicity of cortical tubers revealed by intracranial EEG monitoring.

    abstract:OBJECTIVE:We sought to identify intracranial EEG patterns characteristic of epileptogenic tubers and to understand the contribution of perituberal cortex. METHODS:Twenty-three intracranial EEG monitoring studies were reviewed from 17 children aged 1.3-7.7 years with tuberous sclerosis complex and intractable multifoca...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e3182768923

    authors: Mohamed AR,Bailey CA,Freeman JL,Maixner W,Jackson GD,Harvey AS

    更新日期:2012-12-04 00:00:00

  • Reducing neurodisparity: Recommendations of the 2017 AAN Diversity Leadership Program.

    abstract::Many advances in prevention, diagnosis, and treatment of neurologic disease have emerged in the last few decades, resulting in reduced mortality and decreased disability. However, these advances have not benefitted all populations equally. A growing body of evidence indicates that barriers to care fall along racial an...

    journal_title:Neurology

    pub_type: 杂志文章,评审

    doi:10.1212/WNL.0000000000006874

    authors: Marulanda-Londoño ET,Bell MW,Hope OA,Leacock RO,O'Carroll CB,Posas J 3rd,Stover NP,Young R,Hamilton R

    更新日期:2019-02-05 00:00:00

  • Somatotopic fascicular organization of the human sciatic nerve demonstrated by MR neurography.

    abstract:OBJECTIVES:To investigate whether the human sciatic nerve might have a consistent somatotopic organization according to proximal fascicle input by spinal nerves. METHODS:Twelve patients (55.3 ± 15.5 years) with confirmed lesions of either the L5 or S1 spinal nerve root underwent magnetic resonance neurography of sciat...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000001526

    authors: Bäumer P,Weiler M,Bendszus M,Pham M

    更新日期:2015-04-28 00:00:00

  • Phase I/II multicenter ketogenic diet study for adult superrefractory status epilepticus.

    abstract:OBJECTIVE:To investigate the feasibility, safety, and efficacy of a ketogenic diet (KD) for superrefractory status epilepticus (SRSE) in adults. METHODS:We performed a prospective multicenter study of patients 18 to 80 years of age with SRSE treated with a KD treatment algorithm. The primary outcome measure was signif...

    journal_title:Neurology

    pub_type: 杂志文章,多中心研究

    doi:10.1212/WNL.0000000000003690

    authors: Cervenka MC,Hocker S,Koenig M,Bar B,Henry-Barron B,Kossoff EH,Hartman AL,Probasco JC,Benavides DR,Venkatesan A,Hagen EC,Dittrich D,Stern T,Radzik B,Depew M,Caserta FM,Nyquist P,Kaplan PW,Geocadin RG

    更新日期:2017-03-07 00:00:00

  • Tapping linked to function and structure in premanifest and symptomatic Huntington disease.

    abstract:OBJECTIVE:Motor signs are functionally disabling features of Huntington disease. Characteristic motor signs define disease manifestation. Their severity and onset are assessed by the Total Motor Score of the Unified Huntington's Disease Rating Scale, a categorical scale limited by interrater variability and insensitivi...

    journal_title:Neurology

    pub_type: 杂志文章,多中心研究

    doi:10.1212/WNL.0b013e3182020123

    authors: Bechtel N,Scahill RI,Rosas HD,Acharya T,van den Bogaard SJ,Jauffret C,Say MJ,Sturrock A,Johnson H,Onorato CE,Salat DH,Durr A,Leavitt BR,Roos RA,Landwehrmeyer GB,Langbehn DR,Stout JC,Tabrizi SJ,Reilmann R

    更新日期:2010-12-14 00:00:00

  • Metabolism of (-) deprenyl to amphetamine and methamphetamine may be responsible for deprenyl's therapeutic benefit: a biochemical assessment.

    abstract::The urinary excretion of some important phenylethylamines, catecholamines, their metabolites, amphetamine, and methamphetamine were measured in parkinsonian patients on Sinemet (L-dopa plus carbidopa, a peripheral dopadecarboxylase inhibitor) and depressed patients after chronic (-) deprenyl treatment. Deprenyl was ef...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.32.5.503

    authors: Karoum F,Chuang LW,Eisler T,Calne DB,Liebowitz MR,Quitkin FM,Klein DF,Wyatt RJ

    更新日期:1982-05-01 00:00:00

  • Benign prognosis of never-symptomatic carotid occlusion.

    abstract:OBJECTIVE:To determine the prognosis of asymptomatic carotid artery occlusion. BACKGROUND:As opposed to symptomatic carotid occlusion, little information is available on the prognosis of asymptomatic carotid occlusion. METHOD:Thirty never-symptomatic and 81 symptomatic patients with carotid occlusion underwent baseli...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.54.4.878

    authors: Powers WJ,Derdeyn CP,Fritsch SM,Carpenter DA,Yundt KD,Videen TO,Grubb RL Jr

    更新日期:2000-02-22 00:00:00

  • A double-blind study comparing carbamazepine with phenytoin as initial seizure therapy in adults.

    abstract::Carbamazepine was compared with phenytoin in a double-blind study. Of 87 patients, data on 70 patients were complete and used for analysis. Thirty-five patients were treated with each drug. The incidence of major side effects, minor side effects, and complete control (85%) was the same in both groups. A mild but signi...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1212/wnl.33.7.904

    authors: Ramsay RE,Wilder BJ,Berger JR,Bruni J

    更新日期:1983-07-01 00:00:00

  • Self-awareness of migraine: interpreting the labels that headache sufferers apply to their headaches.

    abstract::Although people with migraine are aware of their headaches they are often not aware that they have migraine. This can lead to inappropriate or ineffective use of treatments, delays in seeking appropriate care, and miscommunication during clinical encounters. This article assesses self-recognition of migraine and ident...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.58.9_suppl_6.s21

    authors: Lipton RB,Stewart WF,Liberman JN

    更新日期:2002-05-14 00:00:00

  • Characteristics of temporal lobe epilepsy with mesial temporal sclerosis, with special reference to psychotic episodes.

    abstract::This study investigates the histories and the clinical course of 111 patients who had nonlesional temporal lobe epilepsy. We compared 61 patients with unilateral hippocampal sclerosis (UHS group) and 50 patients with minimal change (MRI negative group) assessed on the basis of MRI. In agreement with previous reports, ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.47.5.1199

    authors: Kanemoto K,Takeuchi J,Kawasaki J,Kawai I

    更新日期:1996-11-01 00:00:00

  • Small deep infarcts diagnosed on computed tomography.

    abstract::The clinical and angiographic correlations of small deep infarcts seen on computed tomography (CT) scan were studied in 297 consecutive patients. Some of these showed the features described by Fisher as part of the lacunar syndrome. In a large number, a source of emboli from either a cardiac or a carotid source was hi...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.30.10.1090

    authors: Pullicino P,Nelson RF,Kendall BE,Marshall J

    更新日期:1980-10-01 00:00:00

  • Can ethanol intoxication affect hemocoagulation to increase the risk of brain infarction in young adults?

    abstract::We studied the effects of acute ethanol intoxication on platelet function, coagulation factors, and fibrinolytic activity in 12 healthy men. During the ethanol session, 10 of the 12 developed a transient decrease in fibrinolytic activity. Ethanol ingestion increased factor VIII coagulant activity. VIII-related antigen...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.33.3.381

    authors: Hillbom M,Kaste M,Rasi V

    更新日期:1983-03-01 00:00:00

  • Pathogenesis of pseudotumor cerebri syndromes.

    abstract::Intracranial hypertension in the absence of an intracranial mass lesion or hydrocephalus can be caused by an alteration of one or more of the four determinants of cerebrospinal fluid (CSF) pressure: (1) intrasagittal sinus pressure, (2) resistance of arachnoid villi to the egress of CSF, (3) rate of production of CSF,...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.31.7.877

    authors: Donaldson JO

    更新日期:1981-07-01 00:00:00

  • Epileptic skew deviation.

    abstract::We describe a 43-year-old neurologically intact patient who reported episodes of diplopia and oscillopsia associated with a right-beating nystagmus and a skew deviation. These symptoms and signs were related to a left posterior epileptic EEG discharge. We suggest that these ocular motor signs derived from an ictal act...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.50.5.1469

    authors: Galimberti CA,Versino M,Sartori I,Manni R,Martelli A,Tartara A

    更新日期:1998-05-01 00:00:00

  • How experienced community neurologists make diagnoses during clinical encounters.

    abstract::Study of diagnostic practice is necessary to optimize neurologists' clinical performance and ensure patient safety. To our knowledge, this report is the first set of systematic observations of diagnostic practices of community neurologists in their clinics. The study consisted of six 2-week periods of in situ observat...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e3182a840c7

    authors: Dhand A,Engstrom J,Dhaliwal G

    更新日期:2013-10-15 00:00:00

  • Methyl bromide intoxication: neurologic features, including simulation of Reye syndrome.

    abstract::Three family members intoxicated with methyl bromide presented with a variety of neuropsychiatric manifestations including coma, severe status epilepticus, hyporeflexia, and acute psychosis. The simulation of Reye syndrome in the child emphasizes the need for careful toxicologic screening of all children presenting wi...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.27.10.959

    authors: Shield LK,Coleman TL,Markesbery WR

    更新日期:1977-10-01 00:00:00

  • FMR1 CGG repeat length predicts motor dysfunction in premutation carriers.

    abstract:BACKGROUND:Fragile X-associated tremor/ataxia syndrome (FXTAS) is a recently described, underrecognized neurodegenerative disorder of aging fragile X mental retardation 1 (FMR1) premutation carriers, particularly men. Core motor features are action tremor, gait ataxia, and parkinsonism. Carriers have expanded CGG repea...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/01.wnl.0000281692.98200.f5

    authors: Leehey MA,Berry-Kravis E,Goetz CG,Zhang L,Hall DA,Li L,Rice CD,Lara R,Cogswell J,Reynolds A,Gane L,Jacquemont S,Tassone F,Grigsby J,Hagerman RJ,Hagerman PJ

    更新日期:2008-04-15 00:00:00

  • The relevance of VGKC positivity in the absence of LGI1 and Caspr2 antibodies.

    abstract:OBJECTIVE:To assess the clinical relevance of a positive voltage-gated potassium channel (VGKC) test in patients lacking antibodies to LGI1 and Caspr2. METHODS:VGKC-positive patients were tested for LGI1 and Caspr2 antibodies. Patients lacking both antibodies were matched (1:2) to VGKC-negative patients. Clinical and ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000002637

    authors: van Sonderen A,Schreurs MW,de Bruijn MA,Boukhrissi S,Nagtzaam MM,Hulsenboom ES,Enting RH,Thijs RD,Wirtz PW,Sillevis Smitt PA,Titulaer MJ

    更新日期:2016-05-03 00:00:00

  • Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the Guideline Development Subcommittee of the American Academy of Neurology.

    abstract:OBJECTIVE:To update the 1997 American Academy of Neurology (AAN) practice parameter regarding sports concussion, focusing on 4 questions: 1) What factors increase/decrease concussion risk? 2) What diagnostic tools identify those with concussion and those at increased risk for severe/prolonged early impairments, neurolo...

    journal_title:Neurology

    pub_type: 杂志文章,评审

    doi:10.1212/WNL.0b013e31828d57dd

    authors: Giza CC,Kutcher JS,Ashwal S,Barth J,Getchius TS,Gioia GA,Gronseth GS,Guskiewicz K,Mandel S,Manley G,McKeag DB,Thurman DJ,Zafonte R

    更新日期:2013-06-11 00:00:00

  • Hughlings Jackson's clinical research: evidence from contemporary documents.

    abstract::Because Hughlings Jackson directed that his personal documents be destroyed upon his death, none of his own clinical records are known. However, we have discovered several pages of notes in the Royal London Hospital Archive written in 1893 by Jackson to his House Physician at Queen Square concerning his proposals for ...

    journal_title:Neurology

    pub_type: 传,历史文章,杂志文章

    doi:10.1212/01.wnl.0000230142.89488.a0

    authors: Swash M,Evans J

    更新日期:2006-08-22 00:00:00

  • Right-to-left shunt and lacunar stroke in patients without hypertension and diabetes.

    abstract::We analyzed the frequency of cardiac embolic sources in 62 patients with acute lacunar stroke vs 50 controls. In post hoc analysis, 11 patients with lacunar stroke having neither hypertension nor diabetes mellitus (non-HDM group) had a higher frequency of right-to-left shunt (RLS) (82%) than patients with risk factors...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/01.wnl.0000253197.83777.c7

    authors: Ueno Y,Kimura K,Iguchi Y,Shibazaki K,Inoue T,Urabe T

    更新日期:2007-02-13 00:00:00

  • Neuropathological findings in Sneddon's syndrome.

    abstract::The authors report the neuropathologic findings in a case of Sneddon's syndrome. There were multiple small, predominantly cortical, infarcts, with focal hyperplasia and fibrotic occlusion of arterial vessels in the superficial white matter, cortex, and leptomeninges. A very occasional arterial thrombus was seen. These...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/01.wnl.0000055931.66009.d3

    authors: Hilton DA,Footitt D

    更新日期:2003-04-08 00:00:00

  • Immunocytochemical analysis of the cellular infiltrate in brain lesions in subacute sclerosing panencephalitis.

    abstract::We studied lymphocyte subsets and major histocompatibility complex (MHC) class II antigens in frozen brain tissues from three patients with subacute sclerosing panencephalitis (SSPE) using immunocytochemical techniques. Perivascular cuffs consisted predominantly of T cells and MHC class II-positive cells. In the paren...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.41.10.1639

    authors: Nagano I,Nakamura S,Yoshioka M,Kogure K

    更新日期:1991-10-01 00:00:00

  • Aldehyde dehydrogenase variation enhances effect of pesticides associated with Parkinson disease.

    abstract:OBJECTIVE:The objective of this study was to determine whether environmental and genetic alterations of neuronal aldehyde dehydrogenase (ALDH) enzymes were associated with increased Parkinson disease (PD) risk in an epidemiologic study. METHODS:A novel ex vivo assay was developed to identify pesticides that can inhibi...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000000083

    authors: Fitzmaurice AG,Rhodes SL,Cockburn M,Ritz B,Bronstein JM

    更新日期:2014-02-04 00:00:00

  • Autoimmune encephalitis: A costly condition.

    abstract:OBJECTIVE:To assess the inpatient hospitalization burden and costs of patients with autoimmune encephalitis (AE) at a tertiary care institution. METHODS:Adult inpatients with AE were identified retrospectively from July 1, 2005, to June 30, 2015. Demographic and clinical data were collected and analyzed. Billing data ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000006990

    authors: Cohen J,Sotoca J,Gandhi S,Yeshokumar AK,Gordon-Lipkin E,Geocadin RG,Frick KD,Probasco JC,Venkatesan A

    更新日期:2019-02-26 00:00:00

  • Establishment of epilepsy surgery in Peru.

    abstract::Epilepsy surgery is a well-established treatment for certain types of intractable epilepsy. While there is a relatively high number of epilepsy surgery centers in Canada and the United States, the same cannot be said about many other parts of the world, such as South America. Although there are notable exceptions, suc...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000006029

    authors: Steven DA,Vasquez CM,Delgado JC,Zapata-Luyo W,Becerra A,Barreto E,Arango MF,Burneo JG

    更新日期:2018-08-21 00:00:00

  • Exploratory saccades show no direction-specific deficit in neglect.

    abstract::In patients with spatial neglect, contralesional reflexive saccades toward suddenly appearing targets show direction-specific deficits. We examined whether these deficits also occur during free exploration of space. Neglect patients' voluntary eye movements showed reduced amplitudes for saccades in all directions but ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.54.2.515

    authors: Niemeier M,Karnath HO

    更新日期:2000-01-25 00:00:00

  • Why do seizures in generalized epilepsy often occur in the morning?

    abstract:OBJECTIVE:We used transcranial magnetic stimulation to investigate the effect of diurnal variability on cortical excitability in patients with epilepsy. METHODS:Thirty drug-naive patients with epilepsy (20 idiopathic generalized epilepsy [IGE], including 10 juvenile myoclonic epilepsy [JME], and 10 focal epilepsy) and...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e3181ae7ca6

    authors: Badawy RA,Macdonell RA,Jackson GD,Berkovic SF

    更新日期:2009-07-21 00:00:00

  • Education Research: Online Alzheimer education for high school and college students: A randomized controlled trial.

    abstract:OBJECTIVE:Alzheimer disease (AD) risk factors are present throughout the lifespan. This randomized controlled trial evaluated the effectiveness of various online education strategies concerning AD risk reduction and brain health in younger populations. METHOD:High school and college students were recruited via social ...

    journal_title:Neurology

    pub_type: 杂志文章,随机对照试验

    doi:10.1212/WNL.0000000000009859

    authors: Saif N,Niotis K,Dominguez M,Hodes JF,Woodbury M,Amini Y,Sadek G,Scheyer O,Caesar E,Hristov H,Knowlton N,Lee P,McInnis M,Isaacson RS

    更新日期:2020-10-20 00:00:00

  • Fetal akinesia deformation sequence (Pena-Shokeir phenotype) associated with acquired intrauterine brain damage.

    abstract::An infant with Pena-Shokeir phenotype was born to a cocaine-using mother. The pathologic findings included polyhydramnios, facial anomalies, arthrogryposis, camptodactyly, pulmonary hypoplasia, and tetralogy of Fallot. The neuropathologic findings were diffuse brainstem and spinal cord neuronal degeneration and focal ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.41.9.1467

    authors: Lavi E,Montone KT,Rorke LB,Kliman HJ

    更新日期:1991-09-01 00:00:00