Intended for healthcare professionals

Rapid response to:


Permanent loss of awareness is crucial to diagnosis of PVS

BMJ 2003; 327 doi: (Published 10 July 2003) Cite this as: BMJ 2003;327:67

Rapid Response:

Persistent Vegetative State; What's in a Name?

The term Persistent Vegetative State was coined by Fred Plum and
Jerome Posner circa 1965.

If there are unfortunate repercussions because of lay misinterpretation
of the word "vegetative" the fault lies in the communicating skills or
lack thereof of the attendant medical and nursing staff
An alternative term would be
"permanent decorticated state" or if eponyms hide sins, then Plum-Posner
coma might fit.

Certainly one recalls the statement of a victim's mother, quoted by
Teasdale and Jennett, "my son died at the roadway six years before the

Recognition of the syndrome and admission of its devastating cost for
the victim, the parents, and the financing of the health system should
allow a Hospice regime of Morphia ad libatum from a point six to twelve
months after injury, if the diagnosis is unequivocally
supported by clinical and MRI evidence of loss of cortical mantle.

Colin Froman DPhil Oxon (1967) FRCS Ed and Eng (1962)

Competing interests:  
None declared

Competing interests: No competing interests

02 August 2003
Colin Froman
DPhil Oxon, FRCS retired neurosurgeon
formerly Radcliffe Infirmary; University of the Witwatersrand
Herzlia Pituach 46851