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Vegetative state following coma in childhood: evolution and outcome
Developmental Medicine and Child Neurology
|October 1, 1980
Summary
Children in a vegetative state after acute illness and coma have a poor prognosis. Early indicators like decorticate responses and roving eye movements suggest limited recovery potential in pediatric patients.
Area of Science:
- Pediatric Neurology
- Neurocritical Care
- Developmental Pediatrics
Background:
- The vegetative state (VS) in children, following acute illness leading to coma, presents significant challenges in predicting outcomes.
- Understanding the long-term neurodevelopmental impact is crucial for clinical management and family support.
Purpose of the Study:
- To analyze the prognosis and neurodevelopmental outcomes for children diagnosed with the vegetative state.
- To identify potential early clinical indicators of the vegetative state in pediatric patients.
Main Methods:
- Retrospective analysis of data from 17 children with features of the vegetative state.
- Assessment of causes of coma, clinical signs, and neurodevelopmental outcomes at follow-up (2 months to 5 years).
Main Results:
- 15 out of 17 children were under three years old.
- Common causes of coma included diffuse anoxia/ischemia (N=12) and meningitis (N=4).
- Seven children died; 90% of survivors had severe neurodevelopmental handicaps with no cognitive function. One child showed moderate intellectual disability.
Conclusions:
- Children developing a vegetative state after an acute illness and coma face a poor prognosis.
- Decorticate/decerebrate responses, roving eye movements, and spontaneous blinking may serve as early indicators of the vegetative state in children.