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BMJ 2011; 343 doi: (Published 15 November 2011) Cite this as: BMJ 2011;343:d7335

EEG identifies possible awareness in adults in a vegetative state

Researchers have developed a new technique to probe for residual conscious awareness in people thought to be in a persistent vegetative state. Using a form of functional electroencephalography, the researchers identified three patients out of a series of 16 who were able to follow commands. The three young men, two with traumatic and one with hypoxic brain injury, altered their EEG readings consistently when asked to imagine squeezing one hand into a fist or wiggling their toes. In each set of tests they had to repeat one of the tasks 15 times in response to a series of beeps, so they had to both hear and understand verbal instructions. The EEG changes made by the three responsive men matched those made by healthy controls given the same commands and occurred in the appropriate leads for each type of motor imagery.

Others have reported similar findings using functional magnetic resonance imaging. But functional MRI is difficult, stressful, expensive, and rules out anyone who can’t keep still and trauma patients treated with metal implants such as plates or pins. The researchers hope their new technique, which is portable, cheap, and inclusive, will help identify more patients who might have been misdiagnosed using standard behavioural criteria alone.

Thirteen of the patients in this study were unable to follow commands in a way that was detectable using EEG. However, three of the 12 normal controls were also unable to produce the appropriate changes, so a negative result does not necessarily signify lack of consciousness, say the authors.

Chimney stoves cut indoor air pollution and severe pneumonia in Guatemalan children

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Pneumonia is a leading cause of child deaths worldwide, and indoor air pollution from smoky cooking fires is a well established risk factor. Replacing open fires with contained stoves with chimneys can protect children from …

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