The comatose patient

Matthias Girke

Last update: 17.09.2015

The outward unconsciousness of the comatose patient can be accompanied by inner consciousness. For this reason, a comatose patient should be treated as if she were awake and responsive, and her being were only “veiled.” There have been various reports documented of “awake” coma patients. Through what are called event-related brain potentials (ERPs), undetected waking states have been determined in patients in a “persistent vegetative state” or in a coma. The recorded ERPs of these patients were different, for example, when they were told, “Berlin is the capital of Germany”, than when they were told, “Paris is the capital of Germany.” We must act on the assumption of the presence of undetected waking states with the possibility of reflexivity in unconscious patients.

Further studies have shown that waking states can be determined in coma patients using functional magnetic resonance imaging (fMRI). One patient in a persistent vegetative state was asked to imagine that she was playing tennis. Her fMRI showed the same pattern that was documented in the brains of healthy test subjects who are imagining that they are playing tennis.
The contrast between outer unconsciousness and a lucid inner conscious experience with independent reflective capacity is especially impressive in the case of patients with near-death experiences. These observations call into question the relationship between consciousness and the nervous system, and give evidence of conscious experiences which take place independently of the physical body.

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Phase IV trial: Kalium phosphoricum comp. versus placebo in irritability and nervousness 
In a new clinical study, Kalium phosphoricum comp. (KPC) versus placebo was tested in 77 patients per group. In a post-hoc analysis of intra-individual differences after 6 weeks treatment, a significant advantage of KPC vs. placebo was shown for characteristic symptoms of nervous exhaustion and nervousness (p = 0.020, p = 0.045 respectively). In both groups six adverse events (AE) were assessed as causally related to treatment (severity mild or moderate). No AE resulted in discontinuation in treatment. KPC could therefore be a beneficial treatment option for symptomatic relief of neurasthenia. The study has been published open access in Current Medical Research and Opinion

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