Unexpected recovery from a vegetative state or misdiagnosis? Lesson learned from a case report.
Antonino Naro, Rocco Salvatore Calabrò, Patrizia Pollicino and 2 others
PMID 28946586WHAT IT FOUND
A woman diagnosed with a vegetative state for two years emerged into full consciousness after a passive brain connectivity test showed hidden activity typical of a minimally conscious state.
This suggests she may have been misdiagnosed with functional locked-in syndrome, a condition that often goes undetected.
Key findings
01The patient emerged from a vegetative state diagnosis about one year after the test, showing visual pursuit and vocalization.
02She gained full consciousness and functional communication eight months after that, four years after her initial brain injury.
03The authors argue the patient likely had functional locked-in syndrome, a misdiagnosis that explains the unexpected recovery.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a single case report, so the findings cannot be generalized to other patients. The patient received multiple interventions simultaneously (physiotherapy, sensory stimulation, computer programs, and drugs), making it impossible to attribute the recovery to any single factor or to the L-PAS test itself. The L-PAS test is described as experimental and investigational, not a standard clinical tool. The authors admit that passive paradigms like L-PAS cannot directly prove awareness, only suggest preserved connectivity. The time between the test and clinical recovery was unpredictable, limiting the test's utility for prognosis timing.
Declared interests
The authors declare no conflicts of interest and no financial support.
The easy way to misread this
Do not conclude that the L-PAS test caused the recovery or that it is a ready-made clinical diagnostic tool. The patient received extensive rehabilitation and medication concurrently, and the test itself is experimental with unknown validity for routine practice.