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article imageMan wakes from 2 year catatonic state, phones home

By Stephen Morgan     Dec 15, 2014 in Health
A man in a minimally conscious state (MCS) suddenly reawakened and started chatting with hospital staff and relatives after a routine medication was administered.
In a very rare case of a patient suffering from severe brain injury, the man regained full consciousness and began acting normally. The development was a complete surprise for medical staff, who were sending the patient for a routine CT scan.
In preparation for the scan, the patient had been given midazolam, a mild depressant drug of the GABA A agonists family, instead of the usual propofol. He then awoke and began conversing with the anesthetist and later with his family.
While cases of spontaneous recovery have occasionally been seen with similar medications, this was a first with midazolam. Medical experts are now investigating why this took place and have published information about the case in the journal Restorative Neurology and Neuroscience.
The man had suffered major brain injury two years earlier as a result of a car accident and had failed to recover. According to Science Daily, he had been alternatively diagnosed with a form of catatonia and/or minimally conscious state (MCS). The similarities of his symptoms to both conditions meant that he showed signs of catatonic stupor, in which lack of neurological activity left him motionless and MCS which allowed only sporadic symptoms of minimum awareness.
Both conditions are also sometimes confused with persistent vegetative state because of their similarities. However, unlike VS, people with MCS may briefly show elements of awareness, such as recognition of finger movements or can respond to stimuli with their eyes, but this never lasts for long.
Brain scans of various disorders of consciousness  including minimally conscious state
Brain scans of various disorders of consciousness, including minimally conscious state
In this instance, the man reacquired complete consciousness and began acting normally. After chatting with his parents, he then made a phone call to his aunt and also congratulated his brother on his graduation.
However, he had no recall of his accident and wasn't aware of his condition. Unfortunately for him and his parents, he lapsed back into his previous state after just two hours.
Nevertheless, the medical researchers were quick to analyse him and collect information about what was happening using extensive EEG scans. They were able to identify areas in the brain which changed before, during and after the short recovery.
As Science Daily reports, it has also left some unanswered questions over diagnosis and treatment. SD points out that "The authors were thus faced with a two-fold mystery: Is this a case of catatonia mimicking a case of MCS or does the MCS, as a syndrome in itself, also include elements of a catatonic nature?" and "Do the relative contributions of MCS versus catatonia in the individual patient determine whether or not he/she will respond to GABA A agonist drugs?"
Nevertheless, the site TechiDec says that the analysis of the incident may help others. It quotes Maria Chiara Carboncini, MD, Health Care Director of the Brain Damage Unit, Department of Neuroscience, University Hospital of Pisa, Italy, who stated that the research "could pave the way to new perspectives for each treatment and clinical management: at least a portion of MCS individuals could in truth benefit from remedy with non-selective GABA A agonists.”
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