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Journal of Neurology
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Journal of Neurology
Article . 2018 . Peer-reviewed
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Is oral feeding compatible with an unresponsive wakefulness syndrome?

Authors: MELOTTE, Evelyne; MAUDOUX, Audrey; DELHALLE, Sabrina; Martial, Charlotte; Antonopoulos, Georgios; Larroque, Stephen; Wannez, Sarah; +5 Authors

Is oral feeding compatible with an unresponsive wakefulness syndrome?

Abstract

The aim of the study is to explore the possibility of oral feeding in unresponsive wakefulness syndrome/vegetative state (UWS/VS) patients.We reviewed the clinical information of 68 UWS/VS patients (mean age 45 ± 11; range 16-79 years) searching for mention of oral feeding. UWS/VS diagnosis was made after repeated behavioural assessments using the Coma Recovery Scale-Revised. Patients also had complementary neuroimaging evaluations (positron emission tomography, functional magnetic resonance imaging and electroencephalography and diffusion tensor imaging).Out of the 68 UWS/VS patients, only two could resume oral feeding (3%). The first patient had oral feeding (only liquid and semi liquid) in addition to gastrostomy feeding and the second one could achieve full oral feeding (liquid and mixed solid food). Clinical assessments concluded that they fulfilled the criteria for a diagnosis of UWS/VS. Results from neuroimaging and neurophysiology were typical for the first patient with regard to the diagnosis of UWS/VS but atypical for the second patient.Oral feeding that implies a full and complex oral phase could probably be considered as a sign of consciousness. However, we actually do not know which components are necessary to consider the swallowing conscious as compared to reflex. We also discussed the importance of swallowing assessment and management in all patients with altered state of consciousness.

Keywords

Adult, Male, Adolescent, Nutritional Support, Persistent Vegetative State, Administration, Oral, Neuroimaging, Middle Aged, Sciences de la santé humaine, Young Adult, Neurology, Fluorodeoxyglucose F18, Neurologie, Consciousness Disorders, Humans, Female, Human health sciences, Aged, Retrospective Studies

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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30
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