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News of the Day ... In Perspective

07/07/2006

Man regains speech after 19 years in a minimally conscious state

In a “coma” for about 20 years after a severe automobile crash, Terry Wallis is speaking and making jokes, although he thinks Ronald Reagan is President (AP 7/4/06).

Wallis stunned his mother by saying “Mom,” after years of silence, and then over a period of several days gained increasingly fluent though dysarthric speech, with reliable communication.

Doctors at the Stone County Nursing and Rehabilitation Center said that the recovery might be partly attributable to the fact that his family continued to interact with him and took him out for weekends and special occasions (BBC News 7/9/03).

Images of Mr. Wallis’s brain, the first to be taken of a recovering comatose patient, provide evidence that his brain is healing itself by forming new neural connections. Diffusion tensor imaging (DTI) performed at Cornell University showed changes assumed to reflect myelinated fiber density, correlating with marked clinical improvements in motor function. Additionally, PET scans showed increased metabolism in areas of the brain (Voss HU, et al. JCI 2006;116:2005-2011).

“Future research efforts should also address the silent epidemic of VS [vegetative states] and MCS [minimally conscious states] so that these challenging neurological states can emerge from the current dark ages of therapeutic nihilism,” wrote Steven Laureys et al. of the University of Liège (JCI 2006;116:1823-1824).

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