Pagni C A, Giovanelli M, Tomei G, Zavanone M, Signoroni G, Cappricci E
Acta Neurochir (Wien). 1977;36(1-2):37-45. doi: 10.1007/BF01405985.
After the transition state of decerebrate coma, at least four different kinds of the so-called apallic status can be identified: 1. Complete apallic syndrome: coma vigil, alertness without any awareness, mass movements only, impairment of sleep rhythm, absence of any emotional responses, postural abnormalities, some primitive motor responses, tetraplegia, and alteration of muscle tone. 2. Incomplete apallic syndrome: some of the features of the complete apallic syndrome are lacking, and the patient shows emotional reactions with appropriate grimacing and some appropriate motor responses. 3. False apallic syndrome: most signs of complete apallic syndrome are present, but the patient is in touch with the environment. This condition is somewhat similar to the so-called locked-in syndrome. 4. Functional apallic syndrome: full clinical picture of the complete apallic syndrome but full recovery within a few days. Long-term results in 62 patients, aged between 4 and 62, affected by a post-traumatic complete apallic syndrome are reported. Thirty two patients were operated upon and 30 were not operated upon. Out of these cases, 38 died after weeks or months; 3 patients entered a chronic apallic status; 2 patients are improving; 10 recovered with severe neurological or psychic sequels or both; 4 recovered with minimal sequels, and 5 without sequels; no patients in these two last groups were aged more than 20.
在去大脑昏迷的过渡状态之后，至少可以识别出四种不同类型的所谓无动性缄默症：1. 完全性无动性缄默综合征：睁眼昏迷，有警觉但无任何意识，仅有全身性运动，睡眠节律紊乱，无任何情感反应，姿势异常，一些原始运动反应，四肢瘫，以及肌张力改变。2. 不完全性无动性缄默综合征：缺乏完全性无动性缄默综合征的某些特征，患者表现出伴有适当面部表情的情感反应和一些适当的运动反应。3. 假性无动性缄默综合征：存在完全性无动性缄默综合征的大多数体征，但患者与环境有接触。这种情况与所谓的闭锁综合征有些相似。4. 功能性无动性缄默综合征：具有完全性无动性缄默综合征的完整临床表现，但在数天内完全恢复。报告了62例年龄在4岁至62岁之间受创伤后完全性无动性缄默综合征影响的患者的长期结果。32例患者接受了手术，30例未接受手术。在这些病例中，38例在数周或数月后死亡；3例进入慢性无动性缄默状态；2例病情正在改善；10例恢复但伴有严重的神经或精神后遗症或两者皆有；4例恢复且后遗症轻微；5例无后遗症；最后这两组中没有患者年龄超过20岁。
