Originally Posted - May 23, 2006

return home

In 2003, when I was working as a volunteer media coordinator for the Terri Schindler-Schiavo Foundation, I was contacted by a woman from Houston, Texas who told me she believed the prescription drug Ambien could help Terri to improve.

According to her, her adult daughter had been previously diagnosed as being in a chronic persistent vegetative state years earlier. A sympathetic physician prescribed Ambien and, after a very short period of time, the daughter began to show gradual but continuous improvements.

At the time, this suggested to me that her daughter's condition may have been misdiagnosed. According to medical intelligentsia, PVS is an irreversible and incurable condition wherein the patient experiences no cortical activity, has no awareness of self or environment and is unable to understand or communicate.

And they couldn't possibly be wrong.

Today, the BBC has reported that Zolpidem (marketed in the USA under the brand name Ambien) can temporarily revive those patients determined to be in a PVS to the extent they can carry on conversations.

The BBC cites a study conducted by Dr. Ralf Clauss and Wally Nel MB, Ch.B. that observed the results of the use of Zolpidem with a group of patients diagnosed as in PVS.

Their results are rather fascinating:

"All patients were aroused transiently every morning after Zolpidem. Glasgow Coma Scale scores ranged from 6-9/15 before to 10-15/15 after Zolpidem. Rancho Los Amigos Cognitive scores ranged from I-II before to V-VII afterward. Drug efficacy did not decrease and there were no long term side effects after 3-6 years daily use."

Their conclusion was that Zolpidem appeared to be effective in restoring some brain function to patients previously determined to be in a persistent vegetative state.

This directly conflicts with the traditional thinking that PVS is both irreversible and incurable. In a statement to the BBC, Professor Mike Barnes of the Hunters Moor Rehabilitation Centre states "If they (the patients) did have PVS, it would be a remarkable finding, and certainly worth further research."

Agreed.

According to a report released by the British Medical Journal in 1996, 43% of the diagnosed cases of PVS they studied were, in fact, misdiagnosed.

This, apparently, creates a tremendous conundrum for traditional medical intelligentsia that stay fast to the married beliefs that a) patients in a PVS will never recover and; b) the diagnosis is a reliable one.

Through these studies and new findings, it becomes exceedingly clear that neither position is to be safely counted upon.

Certainly, a brain cannot spontaneously regenerate lost tissue. However, there are many renowned experts in neurology and its related sciences who believe surviving matter can absorb the tasks of the tissues lost. The trick has always been finding the mechanism to stimulate that transition.

The results of the Zolpidem study suggest that there may already exist a mechanism to stimulate response and cognition from patients who have suffered massive loss of brain tissue. Conversely, it also suggests the PVS diagnosis does, indeed, miss the mark too often.

As Professor Barnes states, it's certainly worth further research.

Since a PVS diagnosis is a millstone that can be used to cause the death of an undying person, through the removal of ordinary care, we might be well advised to start erring on the side of caution.

That woman in Houston believed it. I would be remiss to argue with her at this point.

Not long ago, the organizers of Not Dead Yet (a disability advocacy group) called for the moratorium of ordinary care removal from patients diagnosed in a persistent vegetative state until more solid medical determinations could be made of the condition.

Now, I'm doing it.

On the Web:
BBC Report - Click Here
Neurorehabilitation Study Brief - Click Here
Misdiagnosis of Persistent Vegetative State - Click Here
Not Dead Yet - Click Here 5-23-06

© 2006 North Country Gazette