Persistent Vegetative State - Causes

Causes

There are three causes of PVS (persistent vegetative state):

1. Acute traumatic brain injury
2. Non-traumatic: neurodegenerative disorder or metabolic disorder of the brain
3. Severe congenital abnormality of the central nervous system.

Medical books (such as Lippincott, Williams, and Wilkins. (2007). In A Page: Pediatric Signs and Symptoms) describe several potential causes of PVS, which are as follows:

• Bacterial, viral, or fungal infection, including meningitis
• Increased intracranial pressure, such as a tumor or abscess
• Vascular pressure which causes intracranial hemorrhaging or stroke
• Hypoxic ischemic injury (hypotension, cardiac arrest, arrhythmia, near-drowning)
• Toxins such as uremia, ethanol, atropine, opiates, lead, colloidal silver
• Trauma: Concussion, contusion
• Seizure, both nonconvulsive status epilepticus and postconvulsive state (postictal state)
• Electrolyte imbalance, which involves hyponatremia, hypernatremia, hypomagnesemia, hypoglycemia, hyperglycemia, hypercalcemia, and hypocalcemia
• Postinfectious: Acute disseminated encephalomyelitis (ADEM)
• Endocrine disorders such as adrenal insufficiency and thyroid disorders
• Degenerative and metabolic diseases including urea cycle disorders, Reye syndrome, and mitochondrial disease
• Systemic infection and sepsis
• Hepatic encephalopathy
• Psychogenic

In addition, these authors claim that doctors sometimes use the mnemonic device AEIOU-TIPS to recall portions of the differential diagnosis: Alcohol ingestion and acidosis, Epilepsy and encephalopathy, Infection, Opiates, Uremia, Trauma, Insulin overdose or inflammatory disorders, Poisoning and psychogenic causes, and Shock.