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Thread: patient in persistent vegetative state and consciousness

  1. #1 patient in persistent vegetative state and consciousness 
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    http://www.cnn.com/2006/HEALTH.....index.html


    Medical profession disagree about understanding terms like consciousness and criteria for diagnosing permanent vegetative state

    Some believe that a patient in persistent vegetative state can experience stimulation.

    For example the patient's eyes may be open and the patient may laugh, cry or appear to track someone who is in the room. A patient in persistent vegetative state might even clench your hand. But this is a very primitive reaction. A newborn baby will grasp your finger, but there is no consciousness.
    When you pinch patients arm he might draw back. Tissue is hurt by the pinch, this generates a response in a receptor, which sends impulse along the peripheral nerves. This impulse travels to thalamus, which directs the arm to withdraw.

    Does this patient feel pain? It is consciousness that determines whether one can "feel" pain. So to feel pain patient’s nervous system must not only recognize stimulation but also send impulse to regions of the brain where consciousness exists. But where is this region???


    As well functional neuroimaging studies have suggested that 'islands' of preserved brain function may exist among patients who have been diagnosed as vegetative. Is existence of those islands enough to proof consciousness awareness in patients who are assumed to be vegetative?


    When we talk specifically about this patient we know that:

    Functional MRI scans showed activation bilaterally in the middle temporal gyrus and superior temporal gyrus in response to intelligible speech. The scan showed also activity in the left inferior frontal region responsible for speech comprehension.
    However, some believe that an appropriate neural response to the significance of spoken sentences, is not unequivocal proof that patient is consciously aware. For example, many studies of learning during anesthesia and sleep, have recognized that many features of human cognition, including speech perception and semantic processing, can go on in the absence of conscious awareness

    The same patient also showed activity in the supplementary motor area,parahippocampal gyrus, posterior parietal cortex, and lateral premotor cortex, regions responsible for visuospatial tasks. Some understand this was her decision to assist by imagining specific tasks when asked. Consequently this should represent a clear act of intention. Again we face here a problem: is ability to modulate own neural activity evidence of consciousness.

    What do you think?


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  3. #2  
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    There is nowhere to draw the line on this. Using and giving definitions won't help...IMHO. I think the more connections are going on in a better working brain, the more consious and more able to perform certain tasks increases. otoh, the more damaged the brain gets the less tasks are able to be performed.

    When you drink too much or get too much drugs in your system or poisoning (mercury/toxic elements) this affects slowly by starting with coordination/memory/problem solving ability and works its way up to more serious brain damaging effects like unable to communicate.

    I know someone who HEAR just fine but can't speak because their brain just cant formulate the right idea.


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    Sure, but it really brings me back to the question what really consciousness is.

    Not only in the medical way but also far beyond. I would not dare to use here the word….. philosophy or common sense.
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    [quote="Tess"]Sure, but it really brings me back to the question what really consciousness is.quote]

    Ok, i see. Well, all jokes aside that is really up to you. Seriously, you could look it up, You could get a lawyer to fight the court system (talking about that recent case where women was vegetative) over what consciousness is, You could get medical terminology on what machines read unconsciousness, You could get some meditationist (?) to say there is really no such thing.

    For me, I listen to all of those people, but have the idea you are always conscious if you can DO something. consciousness to me is being alive. However, if someone is passed out i say "unconscious" and I think that is ok to do.
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    Forum Ph.D. william's Avatar
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    Hi Tess,
    I think you would really enjoy the book called "Sex and the Origins of Death" by William R. Clark. He writes in great detail about this. I really enjoyed the book.

    cheers,
    william
    "... the polhode rolls without slipping on the herpolhode lying in the invariable plane."
    ~Footnote in Goldstein's Mechanics, 3rd ed. p. 202
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    While we are understanding more and more the way our brain work, we still disagree about some definitions like consciousness.
    What is consciousness ?. It seems for me, that this question is still more related to the philosophical field, than the medical one.

    A vegetative state is translated by the defect of numbers of aeras of the brain, and the difficulty to have a real communication and not only reflex (complicated or not)
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  8. #7 Re: patient in persistent vegetative state and consciousnes 
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    Quote Originally Posted by Tess
    http://www.cnn.com/2006/HEALTH.....index.html


    Medical profession disagree about understanding terms like consciousness and criteria for diagnosing permanent vegetative state

    Some believe that a patient in persistent vegetative state can experience stimulation.

    For example the patient's eyes may be open and the patient may laugh, cry or appear to track someone who is in the room. A patient in persistent vegetative state might even clench your hand. But this is a very primitive reaction. A newborn baby will grasp your finger, but there is no consciousness.
    When you pinch patients arm he might draw back. Tissue is hurt by the pinch, this generates a response in a receptor, which sends impulse along the peripheral nerves. This impulse travels to thalamus, which directs the arm to withdraw.

    Does this patient feel pain? It is consciousness that determines whether one can "feel" pain. So to feel pain patient’s nervous system must not only recognize stimulation but also send impulse to regions of the brain where consciousness exists. But where is this region???


    As well functional neuroimaging studies have suggested that 'islands' of preserved brain function may exist among patients who have been diagnosed as vegetative. Is existence of those islands enough to proof consciousness awareness in patients who are assumed to be vegetative?


    When we talk specifically about this patient we know that:

    Functional MRI scans showed activation bilaterally in the middle temporal gyrus and superior temporal gyrus in response to intelligible speech. The scan showed also activity in the left inferior frontal region responsible for speech comprehension.
    However, some believe that an appropriate neural response to the significance of spoken sentences, is not unequivocal proof that patient is consciously aware. For example, many studies of learning during anesthesia and sleep, have recognized that many features of human cognition, including speech perception and semantic processing, can go on in the absence of conscious awareness

    The same patient also showed activity in the supplementary motor area,parahippocampal gyrus, posterior parietal cortex, and lateral premotor cortex, regions responsible for visuospatial tasks. Some understand this was her decision to assist by imagining specific tasks when asked. Consequently this should represent a clear act of intention. Again we face here a problem: is ability to modulate own neural activity evidence of consciousness.

    What do you think?

    i have seen recently an interview with a man who was in a coma and could tell medical staff on his awakening what was said in the room he was in and he recalls his wife kissing him etc.

    he said the feeling wasn't scary and it was like drifting between awake and a dream state. The case is being studied and there are mri tests being done on patients while in that state and asking them to picture certain images, and some results show these mri images match those of a non coma patient.

    there are then implications on what to do with patients in these conditions and if to switch off life support when they could possible be hearing it all with a rational mind

    make you think
    CAPTAINCAVEMAN


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