It's complex, but research suggests some patients in a vegetative state (or Disorder of Consciousness) might perceive pain, even if they can't communicate it, though others show minimal response, and some with subtle awareness (like Minimally Conscious State) likely do. While traditional views focused on lack of consciousness meaning no pain, neuroimaging shows some patients have brain activity in pain-processing areas, suggesting a basic, non-conscious experience, while those with hidden awareness (Cognitive Motor Dissociation) can experience it more fully. Clinical practice leans towards treating these patients with pain relief, acknowledging the possibility of suffering.
People in a vegetative state cannot do things that require thought or conscious intention. They cannot speak, follow commands, move their limbs purposefully, or move to avoid a painful stimulus. Most people in a vegetative state have lost all capacity for awareness, thought, and conscious behavior.
If a vegetative state persists, most patients die within 6 months of the original brain damage. The cause is usually pulmonary infection, urinary tract infection, or multiple organ failure, or death may be sudden and of unknown cause. For most of the rest, life expectancy is about 2 to 5 years (1).
Thus some patients can regain awareness after more than four months in a vegetative state, and, although few reach full independence, most can achieve an improved quality of life within the limitations of their disabilities. The recovery period is prolonged and may continue for several years.
When the brain dies, the person cannot move, breathe, think or feel. Pain or suffering cease. Brain death is death, and cannot be reversed. The heart can continue to beat for awhile as the ventilator (breathing machine) provides oxygen to the body.
In a study by Demertzi and colleagues (19), 2,059 medical and paramedical professionals from 32 European countries were asked the following question: “can a patient in vegetative state feel pain?” Over 40% of those surveyed replied that these patients do not feel pain.
13 most painful medical conditions
However, a person in a vegetative state doesn't show any meaningful responses, such as following an object with their eyes or responding to voices. They also show no signs of experiencing emotions nor of cognitive function.
Even though those in a persistent vegetative state lose their higher brain functions, other key functions such as breathing and circulation remain relatively intact. Spontaneous movements may occur, and the eyes may open in response to external stimuli. Individuals may even occasionally grimace, cry, or laugh.
Life span is significantly reduced in those in a persistent vegetative state, with average life expectancy reported as 2 to 5 years [17]. Survival beyond 10 years is rare. After 12 months in a posttraumatic persistent vegetative state, recovery of consciousness is unlikely in both adults and children [17].
Patients in a vegetative state may have awoken from a coma, but still have not regained awareness. In the vegetative state patients can open their eyelids occasionally and demonstrate sleep-wake cycles, but completely lack cognitive function. The vegetative state is also called a "coma vigil".
The persistent vegetative state is “a form of eyes-open permanent unconsciousness in which the patient has periods of wakefulness and physiological sleep/wake cycles, but at no time is the patient aware of himself or herself or the environment.” If this state persists for more than 3 months in children, the long-term ...
It's important to distinguish brain death from a coma or a vegetative state. In a coma, there is still some brain activity, and the individual may have the potential for recovery. In a vegetative state, there might be partial brain function, but the person lacks awareness and meaningful responsiveness.
Coma is a state of unarousable unresponsiveness. A coma is a deep state of eyes-closed unconsciousness where a person is not able to respond to people or the environment around them. In a coma, a patient is alive and there is some brain activity.
People in a vegetative state can: Open their eyes and blink. Sleep and wake up on a regular schedule. Do basic automatic movements, such as breathing, sucking, chewing, gagging, coughing, and swallowing.
Other studies have shown that up to 20 percent of patients in various vegetative states can hear and respond on at least some level. But at least some of the responses seen could be dismissed as simple reflexes, or at best akin to someone in a dream state responding to stimuli.
Most studies suggest that once brain cells are destroyed or damaged, for the most part, they do not regenerate. However, recovery after brain injury can take place, especially in younger people, as, in some cases, other areas of the brain make up for the injured tissue.
In a vegetative state the person is still unconscious. They have no awareness of themselves or their environment. The main difference between 'coma' and the 'vegetative state' is that at some point the person's eyes will be open and there will be times when they seem to be 'awake'.
Someone in a vegetative state still has a functioning brain stem, which means: some form of consciousness may exist. breathing unaided is usually possible.
Hypoxic Brain Injury
In most cases, the injury is caused by a medical incident or emergency, such as a heart attack or stroke. If an individual does not receive immediate medical attention or help to restore oxygen flow, the brain suffers irreversible damage, possibly leading to death.
People in a vegetative state can do some things because some parts of the brain are functioning: They can open their eyes. They have relatively regular sleeping and waking patterns (but not necessarily related to day and night). They can breathe, suck, chew, cough, gag, swallow, and make guttural sounds.
Does chronic pain ever go away? Currently, there's no cure for chronic pain, other than to identify and treat its cause. For example, treating arthritis can sometimes stop joint pain. Many people with chronic pain don't know its cause and can't find a cure.
The pain from kidney stones can be excruciating and is often compared to the worst stages of labor. Each person's experience varies, but many report that the intensity of kidney stone pain can be overwhelming and debilitating.
It's possible that even in an unconscious, 'pain-free' state that nocifensive responses, like changes in cardiovascular rhythm, persist. So the key ingredient for pain is the conscious brain. Pain= nociception + consciousness. That's enough maths.