Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome

By S. Laureys, G. Celesia, F. Cohadon, J. Lavrijsen, J. León-Carrión, W. Sannita, L. Sazbon, E. Schmutzhard, K. V. von Wild, A. Zeman and 1 more. BMC Medicine, 2010

1,122 citations recorded by the source corpus.

BackgroundSome patients awaken from coma (that is, open the eyes) but remain unresponsive (that is, only showing reflex movements without response to command). This syndrome has been coined vegetative state. We here present a new name for this challenging neurological condition: unresponsive wakefulness syndrome (abbreviated UWS).DiscussionMany clinicians feel uncomfortable when referring to patients as vegetative. Indeed, to most of the lay public and media vegetative state has a pejorative connotation and seems inappropriately to refer to these patients as being vegetable-like. Some political and religious groups have hence felt the need to emphasize these vulnerable patients' rights as human beings. Moreover, since its first description over 35 years ago, an increasing number of functional neuroimaging and cognitive evoked potential studies have shown that physicians should be cautious to make strong claims about awareness in some patients without behavioral responses to command. Given these concerns regarding the negative associations intrinsic to the term vegetative state as well as the diagnostic errors and their potential effect on the treatment and care for these patients (who sometimes never recover behavioral signs of consciousness but often recover to what was recently coined a minimally conscious state) we here propose to replace the name.ConclusionSince after 35 years the medical community has been unsuccessful in changing the pejorative image associated with the words vegetative state, we think it would be better to change the term itself. We here offer physicians the possibility to refer to this condition as unresponsive wakefulness syndrome or UWS. As this neutral descriptive term indicates, it refers to patients showing a number of clinical signs (hence syndrome) of unresponsiveness (that is, without response to commands) in the presence of wakefulness (that is, eye opening).

Subfields: Cognitive Neuroscience, Epidemiology, Psychiatry and Mental health

View Paper: https://www.semanticscholar.org/paper/a1795c6cd9fb50755f4f8a7cdcc65266059aa47f

How researchers see this paper

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In Cognitive Neuroscience

1. Audrey Vanhaudenhuyse
2. Marie-Aurélie Bruno
3. Gustave Moonen
4. Steven Laureys

In Epidemiology

1. Dominika Drążyk
2. K. Przewrocki
3. M. Binder
4. U. Górska
5. Steven Laureys

In Psychiatry and Mental health

1. Audrey Vanhaudenhuyse
2. Steven Laureys

Citations in the corpus

• From unresponsive wakefulness to minimally conscious PLUS and functional locked-in syndromes: recent advances in our understanding of disorders of consciousness (2011, background): “This resulted in last years’ introduction by the European Task Force on Disorders of Consciousness of the term unresponsive wakefulness syndrome [11].”
• Distinct Spectral Profiles of Awake Resting EEG in Disorders of Consciousness: The Role of Frequency and Topography of Oscillations (2022, background): “These include Unresponsive Wakefulness Syndrome (UWS, Laureys et al. 2010), which is characterized by the lack of self-awareness or the awareness of environment (Monti et al. 2010), with preserved irregular sleep cycles as well as intact respiration and thermoregulatory capacity (Gosseries et al.…”