Vegetative State

A vegetative state is when people with brain damage appear to be awake but don't do any purposeful actions or respond to what's going on around them.

• A person in a vegetative state has basic automatic movements, such as breathing, coughing, yawning, or swallowing but doesn't do anything purposeful

• Some people recover, but most die within 6 months

• People in a vegetative state for longer than a few months are unlikely to recover

Vegetative state is different from a coma in that people's eyes are open and they appear to be awake.

A vegetative state happens when:

• The part of the brain that controls thinking and awareness stops working

• The part of the brain that controls breathing, heart rate, and blood pressure continues to work

Causes involve severe brain damage from:

• A head injury

• Lack of oxygen to the brain (such as from drowning or cardiac arrest)

People in a vegetative state can:

• Open their eyes and blink

• Sleep and wake up on a regular schedule

• Do basic automatic movements, such as breathing, sucking, chewing, gagging, coughing, and swallowing

• Be startled by loud sounds

People in a vegetative state can't:

• Be aware of what’s going on around them

• Speak or follow instructions

• Think or move their body on purpose, such as to pull away from something painful

• Control when they urinate or pass stool

People who have some awareness may be in a minimally conscious state.

Doctors suspect a vegetative state based on the person’s symptoms. To tell for sure, they may:

• Closely watch the person for a period of time to see if the person is aware and responsive

• Do tests, such as MRI (magnetic resonance imaging) or CT scan (computed tomorgraphy) of the head

• Do an EEG (electroencephalography—a painless test that records the brain’s electrical activity)

There's no treatment to make a vegetative state get better. People sometimes recover a bit on their own depending on what their original problem was and how severe it was. People don't come back to normal, but a few relearn how to talk and understand people.

A person in a vegetative state needs long-term care, including:

• Feeding by tube

• Frequently turning the person's body to prevent pressure sores

• Medicine to prevent blood clots

• Moving the arms and legs to prevent muscle stiffness

• A tube (catheter) in the bladder to drain urine

• Cleaning and bathing

If a person has been in a vegetative state for a long time and show no signs of recovering, doctors may talk to the family about not giving life-sustaining treatment in the event of a new illness or complication. Doctors and the person's family consider what the person would want and review any instructions available in a living will (advance directive).