A
minimally conscious state (MCS) is a condition distinct from
comaIn medicine, a coma is a profound state of unconsciousness. A comatose person cannot be awakened, fails to respond normally to pain or light, does not have sleep-wake cycles, and does not take voluntary actions....
or the
vegetative stateA persistent vegetative state is a condition of patients with severe brain damage who were in a coma, but then progressed to a state of wakefulness without detectable awareness. It is a diagnosis of some uncertainty in that it deals with a syndrome...
, in which a patient exhibits
deliberateLegal deliberation is the process in which a jury in a trial in court discusses in private the findings of the court and decides by vote with which argument to agree of either opposing side...
, or
cognitivelyCognition is the scientific term for "the process of thought". Usage of the term varies in different disciplines; for example in psychology and cognitive science, it usually refers to an information processing view of an individual's psychological functions...
mediated, behavior often enough, or consistently enough, for clinicians to be able to distinguish it from entirely
unconsciousUnconsciousness, more appropriately referred to as loss of consciousness or lack of consciousness, is a dramatic alteration of mental state that involves complete or near-complete lack of responsiveness to people and other environmental stimuli. Being in a comatose state or coma is an illustration...
,
reflexA reflex action, also known as a reflex, is an involuntary and nearly instantaneous movement in response to a stimulus. In most contexts, in particular those involving humans, reflex actions are mediated via the reflex arc; this is not always true in other animals, nor does it apply to casual uses...
ive responses.
Patients with severe
brain damageBrain damage, or acquired brain injury, is the destruction or degeneration of brain cells.-Causes:Brain damage may occur due to a wide range of conditions, illnesses, injuries, and as a result of iatrogenesis...
may progress through stages of
unconsciousnessUnconsciousness, more appropriately referred to as loss of consciousness or lack of consciousness, is a dramatic alteration of mental state that involves complete or near-complete lack of responsiveness to people and other environmental stimuli. Being in a comatose state or coma is an illustration...
with eyes closed (
comaIn medicine, a coma is a profound state of unconsciousness. A comatose person cannot be awakened, fails to respond normally to pain or light, does not have sleep-wake cycles, and does not take voluntary actions....
), to unconsciousness with eyes open (vegetative state), to a stage of "inconsistent, erratic responsiveness" (minimally conscious state).
A
minimally conscious state (MCS) is a condition distinct from
comaIn medicine, a coma is a profound state of unconsciousness. A comatose person cannot be awakened, fails to respond normally to pain or light, does not have sleep-wake cycles, and does not take voluntary actions....
or the
vegetative stateA persistent vegetative state is a condition of patients with severe brain damage who were in a coma, but then progressed to a state of wakefulness without detectable awareness. It is a diagnosis of some uncertainty in that it deals with a syndrome...
, in which a patient exhibits
deliberateLegal deliberation is the process in which a jury in a trial in court discusses in private the findings of the court and decides by vote with which argument to agree of either opposing side...
, or
cognitivelyCognition is the scientific term for "the process of thought". Usage of the term varies in different disciplines; for example in psychology and cognitive science, it usually refers to an information processing view of an individual's psychological functions...
mediated, behavior often enough, or consistently enough, for clinicians to be able to distinguish it from entirely
unconsciousUnconsciousness, more appropriately referred to as loss of consciousness or lack of consciousness, is a dramatic alteration of mental state that involves complete or near-complete lack of responsiveness to people and other environmental stimuli. Being in a comatose state or coma is an illustration...
,
reflexA reflex action, also known as a reflex, is an involuntary and nearly instantaneous movement in response to a stimulus. In most contexts, in particular those involving humans, reflex actions are mediated via the reflex arc; this is not always true in other animals, nor does it apply to casual uses...
ive responses.
Patients with severe
brain damageBrain damage, or acquired brain injury, is the destruction or degeneration of brain cells.-Causes:Brain damage may occur due to a wide range of conditions, illnesses, injuries, and as a result of iatrogenesis...
may progress through stages of
unconsciousnessUnconsciousness, more appropriately referred to as loss of consciousness or lack of consciousness, is a dramatic alteration of mental state that involves complete or near-complete lack of responsiveness to people and other environmental stimuli. Being in a comatose state or coma is an illustration...
with eyes closed (
comaIn medicine, a coma is a profound state of unconsciousness. A comatose person cannot be awakened, fails to respond normally to pain or light, does not have sleep-wake cycles, and does not take voluntary actions....
), to unconsciousness with eyes open (vegetative state), to a stage of "inconsistent, erratic responsiveness" (minimally conscious state).
It is not known whether patients in MCS can process
emotionAn emotion is a mental and physiological state associated with a wide variety of feelings, thoughts, and behavior. Emotions are subjective experiences, often associated with mood, temperament, personality, and disposition. The English word 'emotion' is derived from the French word émouvoir...
. MCS is thought to have a more favorable outcome than persistent vegetative state.
Doctors in the USA recently succeeded in bringing a man who had been under MCS for six years back to consciousness by planting electrodes deep inside his brain. If the success can be more widely replicated, it offers hope for many of the up to 300,000 MCS sufferers in the USA today.
Brain damage actually differs case to case and terms are not well set.
Notable MCS patients
- Terry Wallis
Terry Wallis is an American man living in the Ozark Mountains of Arkansas who on June 11, 2003 regained awareness after spending almost 20 years in a minimally conscious state....
- Gary Dockery
Gary French Dockery , was a police officer in Walden, Tennessee who made world headlines after emerging from a 7½ year coma-like state and started talking enthusiastically, recognizing friends and recalling events from past years....
- Chi Cheng (musician)
Chi Cheng, is an American musician and the bass guitarist in the band Deftones.-Personal life:Cheng attempted a BA in English Literature from CSU Sacramento and is the only member of the band to make such an attempt. He is the author of a collection of poetry entitled The Bamboo Parachute released...
- Dorothy Crater
- George Melendez
- Jawad Pasha
Jawad Pasha of Pakistan is claimed to be the world's best maintained and much recovered Persistent Vegetative State or minimally conscious state patient....
Further reading
- Giacino JT, Ashwal S, Childs N, et al. "The minimally conscious state: definition and diagnostic criteria". Neurology 2002;58:349–53
- Boly M, Faymonville ME, Peigneux P, et al. "Auditory processing in severely brain injured patients: differences between the minimally conscious state and the persistent vegetative state". Archives of Neurology 2004;61:233–8.
- Hobson JA. "Consciousness as a state-dependent phenomenon". In Cohen JD, Schooler JW (eds). Scientific approaches to consciousness. Mahwah, NJ:Lawrence Earlbaum Assoc., 1997.
- Giacino JT, Kalmar K. "The vegetative and minimally conscious states: a comparison of clinical features and functional outcome." Journal of Head Trauma Rehabilitation 1997; 12: 36-51.
- Ford GP, Reardon DC. "Prolonged unintended brain cooling may inhibit recovery from brain injuries: case study and literature review." Med Sci Monit. 2006 Aug;12(8):CS74-9. Epub 2006 Jul 12. http://www.medscimonit.com/pub/vol_12/no_8/8795.pdf
- Emily Singer "Raising Consciousness" Technology Review Jan/Feb 2007