According to CNN’s Anderson Cooper, for decades now, individuals in a minimally conscious state have been given little hope by the medical community, and have been essentially written off and placed in nursing homes.
Take the case of George Melendez, who suffered a brain injury when he crashed his car about ten years ago, weeks after the accident doctors told his mother (Pat Flores) that her son would never get better. Pat refused to accept this diagnosis, believing her son was “always there, just unable to communicate”. Pat cared for George at home while tirelessly looking for new treatments. Then one night in 2002 Pat gave George some Ambien, as his restlessness had been keeping her awake. The results were not what she expected; instead of putting George to sleep he became more alert.
Pat says she has now been administering Ambien every day for the last five years. Dr. Schiff of Cornell in New York did a before and after PET scan to determine if Ambien was actually helping George or if it was a product of Pat’s wishful thinking. In the first PET scan taken before Ambien was administered the frontal lobe showed up as yellow, indicating greatly reduced brain activity. The second PET scan, taken after she administered Ambien, showed the same areas in bright red, which indicated that the activity in the frontal lobe was two to three times more intense than without the Ambien.
There are several clinical trials of Ambien underway, but progress is slow, in part because minimally conscious people are scattered around the country in homes and nursing facilities, often far from research centers.
Another obstacle to treating these people is that they’re frequently misdiagnosed — said to be in a vegetative state, a more severe condition, considered hopeless after the first year.
“There have been some recent studies looking to see what the misdiagnosis rate was and they come up with a number of 40 percent,” Dr. Schiff says. “So the number of patients who are said to be in a vegetative state, who may actually be in a minimally conscious state, could be as high as 40 percent, 20, 30, 40 percent?” Cooper asks.
“In some context,” Schiff says.
Why were people misdiagnosed?
Says Schiff, “You have to examine them repeatedly and at different times of the day, and sometimes just changing a patient’s posture, or giving them a tendon massage, may change their level sufficiently to elicit some response. So yeah, this is an evolving area of understanding.”
Dr. Adrian Owen, a neuroscientist from the Medical Research Council in Cambridge, England, thinks new technology may help diagnose these people earlier and more accurately than a bedside exam.