Dept of Neurology, Cyclotron Research Centre, University Hospital and University of Liège, Belgium.
BMC Med. 2010 Nov 1;8:68. doi: 10.1186/1741-7015-8-68.
Some patients awaken from coma (that is, open the eyes) but remain unresponsive (that is, only showing reflex movements without response to command). This syndrome has been coined vegetative state. We here present a new name for this challenging neurological condition: unresponsive wakefulness syndrome (abbreviated UWS).
Many clinicians feel uncomfortable when referring to patients as vegetative. Indeed, to most of the lay public and media vegetative state has a pejorative connotation and seems inappropriately to refer to these patients as being vegetable-like. Some political and religious groups have hence felt the need to emphasize these vulnerable patients' rights as human beings. Moreover, since its first description over 35 years ago, an increasing number of functional neuroimaging and cognitive evoked potential studies have shown that physicians should be cautious to make strong claims about awareness in some patients without behavioral responses to command. Given these concerns regarding the negative associations intrinsic to the term vegetative state as well as the diagnostic errors and their potential effect on the treatment and care for these patients (who sometimes never recover behavioral signs of consciousness but often recover to what was recently coined a minimally conscious state) we here propose to replace the name.
Since after 35 years the medical community has been unsuccessful in changing the pejorative image associated with the words vegetative state, we think it would be better to change the term itself. We here offer physicians the possibility to refer to this condition as unresponsive wakefulness syndrome or UWS. As this neutral descriptive term indicates, it refers to patients showing a number of clinical signs (hence syndrome) of unresponsiveness (that is, without response to commands) in the presence of wakefulness (that is, eye opening).
有些患者从昏迷中苏醒（即睁眼），但仍无反应（即仅出现反射运动，对指令无反应）。这种综合征被称为植物状态。我们在此为这种具有挑战性的神经状况提出一个新名称：无反应性觉醒综合征（简称 UWS）。
许多临床医生在提到植物人时感到不舒服。事实上，对于大多数外行人来说，植物状态带有贬义词的含义，将这些患者称为植物人似乎不恰当。一些政治和宗教团体因此感到有必要强调这些脆弱患者作为人的权利。此外，自 35 多年前首次描述以来，越来越多的功能神经影像学和认知诱发电位研究表明，医生应该谨慎地对一些没有行为反应的患者做出有关意识的强烈声明。鉴于术语植物状态所固有的负面联想以及这些诊断错误及其对这些患者的治疗和护理的潜在影响（这些患者有时从未恢复行为意识迹象，但经常恢复到最近被称为最小意识状态），我们在此提议更换名称。
由于 35 年来医学界未能改变与植物状态相关的贬义词形象，我们认为最好还是更改术语本身。我们在此为医生提供将这种情况称为无反应性觉醒综合征或 UWS 的可能性。正如这个中性描述性术语所表明的那样，它指的是表现出一系列无反应（即对指令无反应）的临床体征（即综合征）的患者，但同时存在觉醒（即睁眼）。
