Coma Misdiagnosis: Man trapped in his body for 23 years

[SnoMan]

EDIT: This case is subject to debate. What follows is an article accounting the story from the Guardian. After that is an article by James Randi in opposition to this case. Discuss.
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Kinda scary...but it's good to know that this will bring forward more and better testing in cases of coma.

http://www.guardian.co.uk/world/2009...-coma-23-years

For 23 years Rom Houben was *imprisoned in his own body. He saw his doctors and nurses as they visited him during their daily rounds; he listened to the conversations of his carers; he heard his mother deliver the news to him that his father had died. But he could do nothing. He was unable to communicate with his doctors or family. He could not move his head or weep, he could only listen.

Doctors presumed he was in a vegetative state following a near-fatal car crash in 1983. They believed he could feel nothing and hear nothing. For 23 years.

Then a neurologist, Steven Laureys, who decided to take a radical look at the state of diagnosed coma patients, released him from his torture. Using a state-of-the-art scanning system, Laureys found to his amazement that his brain was functioning almost normally.

"I had dreamed myself away," said Houben, now 46, whose real "state" was discovered three years ago, according to a report in the German magazine Der Spiegel this week.

Laureys, a neurologist at the *University of Liege in Belgium, published a study in BMC Neurology earlier this year saying Houben could be one of many cases of falsely diagnosed comas around the world. He discovered that although Houben was completely paralysed, he was also completely conscious — it was just that he was unable to communicate the fact.

Houben now communicates with one finger and a special touchscreen on his wheelchair – he has developed some movement with the help of intense physiotherapy over the last three years.

He realised when he came round after his accident, which had caused his heart to stop and his brain to be starved of oxygen for several minutes, that his body was paralysed. Although he could hear every word his doctors spoke, he could not communicate with them.

"I screamed, but there was nothing to hear," he said, via his keyboard.

The Belgian former engineering student, who speaks four languages, said he coped with being effectively trapped in his own body by meditating. He told doctors he had "travelled with my thoughts into the past, or into another existence altogether". Sometimes, he said, "I was only my consciousness and nothing else".

The moment it was discovered he was not in a vegetative state, said Houben, was like being born again. "I'll never forget the day that they discovered me," he said. "It was my second birth".

Experts say Laureys' findings are likely to reopen the debate over when the decision should be made to terminate the lives of those in comas who appear to be unconscious but may have almost fully-functioning brains.

Belgian doctors used an internationally-accepted scale to monitor Houben's state over the years. Known as the Glasgow Coma Scale, it requires assessment of the eyes, verbal and motor responses. But they failed to assess him correctly and missed signs that his brain was still functioning.

Last night his mother, Fina, said in an interview with Belgian RTBF that they had taken him to the US five times for reexamination. The breakthrough came when it became clear that Houben could indicate yes and no with his foot.
"Powerlessness. Utter powerlessness. At first I was angry, then I learned to live with it," he tapped out on to the screen during an interview with the Belgian network last night, AP reported.

Laureys, who is head of the Coma Science Group and department of neurology at Liege University hospital, has advised on several prominent coma cases, such as the American Terri Schiavo, whose life support was withdrawn in 2005 after 15 years in a coma.

Laureys concluded that coma patients are misdiagnosed "on a disturbingly regular basis". He examined 44 patients believed to be in a vegetative state, and found that 18 of them responded to communication.

"Once someone is labelled as being without consciousness, it is very hard to get rid of that," he told Der Spiegel.

He said patients suspected of being in a non-reversible coma should be "tested 10 times" and that comas, like sleep, have different stages and need to be monitored.

Houben hopes to write a book detailing his trauma and his "rebirth".

EDIT: James Randi link on this provided by Threshar This Cruel Farce Has To Stop!

[RickenBoogie]

Facinating, and not just a little scary.

[René_Julien]

This was a news story here in august. Through the slow gears of the medical world it now has caught the attention of the international media.

It was here on the news again today.


The man is very happy that now he is not treated as a coma patient anymore. He has an optimistic view on his present situation and the future.
They are working on his recovery.

He can not speak and can barely move.
He needs some aid when typing on the keyboard.

I hope he can recover and enjoy life again.


He coped with it those 23 years very well mentally. Mostly he dreamt and fantasized a lot. Not hallucinating. He kept his mind working and kept his sanity.
Which is something amazing I think. Many people would have gone crazy with this kind of isolation.

He did state the it was some sort of torture and frustrating that nobody knows he was consience.

[MakiSupaStar]

Amazing. I'm glad to see that he didn't witness anyone abusing him.

[doctorjazz]

I'd be pretty interested in reading that book whenever he writes it, got to wonder what kind of thoughts a man has when he's done literally nothing but meditate for 20+ years.

[Armueller2001]

The song "one" by Metallica comes to mind

[RWP]

Originally Posted by MakiSupaStar

Amazing. I'm glad to see that he didn't witness anyone abusing him.

Wasn't there a Twilight Zone about this?

[Steve]

That guy was concious and alert with a flat EEG???

Or is a thorough, periodic EEG not part of the normal standard of care in Belgium?

Bizarre.

[XtreO]

I'm thinking One by Metallica. If this happened to me, I'd rather be dead.


Why of course, this has allready been said I gotta learn to do mroe than skim through topics

[Febs]

He seems to be completely unreceptive.
The tests I gave him showed no sense at all.
His eyes react to light; the dials detect it.
He hears but cannot answer to your call.

See me, feel me, touch me, heal me.
See me, feel me, touch me, heal me.

There is no chance, no untried operation.
All hope lies with him and none with me.
Imagine though the shock from isolation,
When he suddenly can hear and speak and see.

See me, feel me, touch me, heal me.
See me, feel me, touch me, heal me.

[smperry]

That is scary!

[MadMan118]

Originally Posted by Steve

That guy was concious and alert with a flat EEG???

Or is a thorough, periodic EEG not part of the normal standard of care in Belgium?

Bizarre.

People in a coma have a pulse you know.

[Steve]

Originally Posted by MadMan118

People in a coma have a pulse you know.

*sigh*
As a matter of fact, I do know. Do you?
Possibly you are confusing EEG which is a standard test for brain function with EKG (or more correctly, ECG) ElectroCardioGram which is a test of the cardiac function.

[makanudo]

Originally Posted by Armueller2001

The song "one" by Metallica comes to mind

Originally Posted by XtreO

I'm thinking One by Metallica. If this happened to me, I'd rather be dead.


Why of course, this has allready been said I gotta learn to do mroe than skim through topics

totally

[Bassman316]

This is more than a little scary. This man has extraordinary mental capabilities if he was able to keep calm and not go mentally insane during all of that. Can you imagine being trapped in your own body, being completely conscious but not being able to speak or move or even open your eyes? It freaks me the hell out when I have a spell of sleep paralysis, and that only lasts for a minute or two. Not trying to equate sleep paralysis with a coma, a coma being a much more severe medical condition, but the sensation of sleep paralysis is a very overwhelming feeling, at least for me it is, and the thought of being trapped in that kind of physical and mental state of panic for TWENTY THREE YEARS, and to be able to stay sane throughout the whole thing seems freaggin' superhuman to me. Seriously.

[Murder_Worship]

Fuuuuuuuuuuuuuuuuuuuuu

[hbarcat]

Originally Posted by Steve

That guy was concious and alert with a flat EEG???

Or is a thorough, periodic EEG not part of the normal standard of care in Belgium?

Bizarre.

According to the story, he was diagnosed as being in a "vegetative state". They used standard testing for the Glasgow Coma Scale to determine this. Patients who are diagnosed as being in a vegetative state or persistent vegetative state always read activity on an EEG. If they didn't, then they would be labeled as "brain dead".

[L-A]

Originally Posted by hbarcat

According to the story, he was diagnosed as being in a "vegetative state". They used standard testing for the Glasgow Coma Scale to determine this. Patients who are diagnosed as being in a vegetative state or persistent vegetative state always read activity on an EEG. If they didn't, then they would be labeled as "brain dead".

^ I was about to correct that too. Basically, you covered it. Diagnosing someone of a conscious total paralysis instead of coma requires very precise knowledge of what you're looking for.

This doctor's initiative is definitely a big step for medicine.

[Steve]

They used the GCS to diagnose a persistent vegetative state????

You have got to be kidding me.

It's not a question if there is electrical activity present on an EEG so much as where in the brain the activity is and how much activity there is.

A person "Trapped inside their own body" is going to have a vastly different EEG than someone in a coma. In either case the GCS will be 3. That is why it is a totally inappropriate measure.

When I was a paramedic, if I had taken someone into the ER and said, "He's has a GCS of 4, he's in a vegitative state" or, "He's in a coma", several people would have ripped me a new one.

Ah...there it is. I missed it the first time.
"Belgian doctors used an internationally-accepted scale to monitor Houben's state over the years. Known as the Glasgow Coma Scale, it requires assessment of the eyes, verbal and motor responses. But they failed to assess him correctly and missed signs that his brain was still functioning."

I guess so. Duh!

[jazzy grille]

Worst fear evar.

I can't even imagine the psychological processes that he must have went through dealing with being conscious in that state and not being able to vent emotions.