Teresa is a 21-year-old female who was involved in a motor vehicle accident. She was ejected from her truck upon impact with another vehicle and suffered a significant brain injury. Her GCS in the field was 12 and improved to 13 upon admission to the emergency room. Currently, Teresa demonstrates appropriate behavior in response to environmental stimuli, but inconsistent arousal. She also attempts to utter sounds during her periods of arousal through her speech is unintelligible. She can move all four extremities, but is inconsistent upon command.
Which of the following best matches Teresa's current status?
locked-in syndrome
coma
persistent vegetative state
minimally conscious state
C?
I would agree with C
No, the correct answer is persistent vegetative state.
Here's how you can arrive at this answer:
1. Understand the definitions of the given options:
- Locked-in syndrome: A condition where a person is aware and awake but cannot move or communicate due to complete paralysis of all voluntary muscles except for the eyes.
- Coma: A state of prolonged unconsciousness where a person is unresponsive and does not exhibit any purposeful behavior.
- Persistent vegetative state: A condition where a person is awake and has sleep-wake cycles but does not exhibit any meaningful cognitive or higher brain functions.
- Minimally conscious state: A condition where a person has inconsistent and minimal signs of consciousness and awareness.
2. Assess Teresa's symptoms based on the information provided:
- GCS score: 12 in the field, improving to 13 upon admission: This indicates a moderate brain injury but still has some level of consciousness and response to stimuli.
- Appropriate behavior in response to environmental stimuli: Teresa can show responses to environmental inputs, suggesting some level of awareness.
- Inconsistent arousal: Teresa's level of arousal is not stable and fluctuates.
- Unintelligible speech: Teresa attempts to make sounds but her speech is incomprehensible.
- Inconsistent movement upon command: Teresa's ability to follow commands is not reliable.
3. Compare Teresa's symptoms with the definitions:
- Locked-in syndrome: Teresa has inconsistent arousal and motor response, and her speech is unintelligible. Unlike locked-in syndrome, she has no paralysis or inability to move her eyes.
- Coma: Teresa's level of arousal and response to environmental stimuli indicate that she is not in a coma.
- Persistent vegetative state: This condition matches Teresa's symptoms the best. She demonstrates inconsistent arousal, unintelligible speech, and inconsistent movement upon command.
- Minimally conscious state: Teresa's symptoms are more consistent with a persistent vegetative state rather than a minimally conscious state.
Therefore, the correct answer is persistent vegetative state.