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01-04-2018 | Original Communication

Is oral feeding compatible with an unresponsive wakefulness syndrome?

Authors: Evelyne Mélotte, Audrey Maudoux, Sabrina Delhalle, Charlotte Martial, Georgios Antonopoulos, Stephen Karl Larroque, Sarah Wannez, Marie-Elisabeth Faymonville, Jean-François Kaux, Steven Laureys, Olivia Gosseries, Audrey Vanhaudenhuyse

Published in: Journal of Neurology | Issue 4/2018

Abstract

Objective

The aim of the study is to explore the possibility of oral feeding in unresponsive wakefulness syndrome/vegetative state (UWS/VS) patients.

Method

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).

Results

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.

Conclusion

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.

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Title: Is oral feeding compatible with an unresponsive wakefulness syndrome?
Authors: Evelyne Mélotte
Audrey Maudoux
Sabrina Delhalle
Charlotte Martial
Georgios Antonopoulos
Stephen Karl Larroque
Sarah Wannez
Marie-Elisabeth Faymonville
Jean-François Kaux
Steven Laureys
Olivia Gosseries
Audrey Vanhaudenhuyse
Publication date: 01-04-2018
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 4/2018
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-018-8794-y

At a glance: The STEP trials

Springer Medicine

Is oral feeding compatible with an unresponsive wakefulness syndrome?

Abstract

Objective

Method

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Method

Results

Conclusion

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