Vegetative State Following Coma in Childhood: Evolution and Outcome

Abstract

The data have been analysed for 17 children who showed features of the vegetative state following an acute illness that resulted in coma. 15 were under three years of age. Diffuse anoxia/ischaemia (N=12) and meningitis (N=4) were the most common causes of the comatose state. Seven children died, and nine of the 10 survivors have remained severely neurodevelopmentally handicapped, with no cognitive function (follow-up two months to five years). One child became ambulant a year after the initial insult and is moderately retarded. The findings suggest that children who develop the vegetative state following an illness resulting in coma have a poor prognosis and that decorticate or decerebrate responses, roving eye-movements and spontaneous blinking may be early indicators of its emergence.