[Prognosis of the apallic syndrome. A literature review]

This study evaluates the available literature about the prognosis of patients with apallic syndrome and similar illnesses. Different therapeutic strategies are not relevant in this review. The variation of the reported material did not permit a statistical metaanalysis. However, many interesting points of view could be elaborated leading to positive assistance in everyday situations. The chance of survival and the long-term outcome of comatose patients decrease with an increase in the age of the patient, the length and the degree of the coma. Cerebral predamage worses the long-term prognosis. Traumatic head injuries have a better prognosis than nontraumatic. Children (under 18 years of age) have a better prognosis than adults. The course of the oculomotoric symptoms can be used as a prognostic criterion. The somatosensory evoked potentials in the early phase correlate with the survival-chance and the long-term prognosis. The initial speed of recovery correlates with the long term outcome. Children and adults with traumatic apallic syndrome may recover over a period of 12 months. For apallic patients with other etiologies this time limit is 3 months. Few cases of recovery have been described outside these time limits. The average survival limit of permanent apallic patients is between 3 and 5 years. Particular patients have survived decades.