{"id":2358,"date":"2014-10-16T15:31:02","date_gmt":"2014-10-16T15:31:02","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/ccevp\/"},"modified":"2026-04-07T20:23:38","modified_gmt":"2026-04-07T20:23:38","slug":"ccevp","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/ccevp\/","title":{"rendered":"Diagnostic Criteria for Vegetative State (VS)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>A vegetative state is absence of responsiveness and awareness due to overwhelming dysfunction of the cerebral hemispheres, with sufficient sparing of the diencephalon and brain stem to preserve autonomic and motor reflexes and sleep-wake cycles.<br \/>\n<!--more--><br \/>\n<strong>Diagnostic Criteria for Vegetative State<\/strong><\/p>\n<p><strong>Preconditions<\/strong><br \/>\nThe following preconditions must apply before diagnosis\u00a0of the VS can be considered.<\/p>\n<ol>\n<li>The cause of the condition should be established as far as\u00a0is possible. It may be due to acute cerebral injury,\u00a0degenerative conditions, metabolic disorders, infections or developmental malformations.<\/li>\n<li>The possibility that the persisting effects of sedative,\u00a0anaesthetic or neuromuscular blocking drugs are\u00a0responsible in whole or part should be considered. Drugs\u00a0may have been the original cause of an acute cerebral\u00a0injury, usually hypoxic, but their continuing direct effects\u00a0must be excluded either by the passage of time or by\u00a0appropriate laboratory tests.<\/li>\n<li>The possibility that continuing metabolic disturbance is\u00a0responsible for the clinical features must be considered\u00a0and excluded. Metabolic disturbances may of course occur during the course of a VS.<\/li>\n<li>The possibility that there is a treatable structural cause\u00a0should be excluded by brain imaging.<\/li>\n<\/ol>\n<p><strong>Clinical criteria<\/strong><br \/>\nThe following criteria are usualy met.<\/p>\n<ol>\n<li>The key requirement for diagnosis is that there must be no evidence of awareness of self or environment at any\u00a0time; no response to visual, auditory, tactile or noxious\u00a0stimuli of a kind suggesting volition or conscious\u00a0purpose; no evidence of language comprehension or meaningful expression. These are al necessary conditions\u00a0for the diagnosis.<\/li>\n<li>There are typically cycles of eye closure and eye opening\u00a0giving the appearance of a sleep\u2013wake cycle.<\/li>\n<li>Hypothalamic and brainstem function are usually\u00a0sufficiently preserved to ensure the maintenance of\u00a0respiration and circulation.<\/li>\n<\/ol>\n<p>Criteria 2 and 3 are usually satisfied by patients in the vegetative state but, unlike the first criterion, they are not obligatory\u00a0(thus, for example, a patient with cerebral injuries sufficient to\u00a0cause the vegetative state might, incidentally, have third nerve palsies preventing eye opening, or injuries to the chest or medula affecting respiratory function).<br \/>\nThe persistent vegetative state can be defined as a vegetative state present at 1 month after acute traumatic\u00a0or nontraumatic brain injury, and present for at least 1 month in degenerative\/metabolic disorders or developmental\u00a0malformations.<br \/>\nThe permanent vegetative state means an irreversible state, a definition, as with all clinical diagnoses in\u00a0medicine, based on probabilities, not absolutes. A\u00a0persistent vegetative state\u00a0patient becomes permanently vegetative when the diagnosis\u00a0of irreversibility can be established with a high degree of clinical certainty, ie, when the chance of regaining\u00a0consciousness is exceedingly rare.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Royal College of Physicians. The vegetative state: guidance on diagnosis and management. Clin Med. 2003 May-Jun;3(3):249-54.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/12848260\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>The Quality Standards Subcommittee of the American Academy of Neurology. Practice parameters: assessment and management of patients in the persistent vegetative state. Neurology. 1995 May;45(5):1015-8.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/7746375\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Zheng H, Tian L, Cai J. Meta-analysis of the diagnostic value of functional magnetic resonance imaging for distinguishing unresponsive wakefulness syndrome\/vegetative state and minimally conscious state. Front Neurosci. 2024 Sep 9;18:1395639. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39315080\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Oct 24, 2014.<br \/>\nUp-date Apr 7, 2026.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[148],"tags":[16,15,14,13,886,885,884,883,882,881,880,887],"class_list":["post-2358","post","type-post","status-publish","format-standard","hentry","category-critical-care","tag-criteria","tag-criterios","tag-diagnostic","tag-diagnostico","tag-estado-vegetativo","tag-permanent","tag-permanente","tag-persistent","tag-persistente","tag-state","tag-vegetative","tag-vs"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2358","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2358"}],"version-history":[{"count":4,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2358\/revisions"}],"predecessor-version":[{"id":10734,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2358\/revisions\/10734"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2358"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2358"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2358"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}