Unpublished conference/Abstract (Scientific congresses and symposiums)
Is oral feeding compatible with an unresponsive wakefulness syndrome?
MELOTTE, Evelyne; MAUDOUX, Audrey; DELHALLE, Sabrina et al.
2018Joint Congress of the DCRM, BNF-PRM and RBSPRM 2017
Peer reviewed
 

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Keywords :
swallowing; altered of consciousness
Abstract :
[en] Introduction : Vegetative state/unresponsive wakefulness syndrome (VS/UWS) is defined by the presence of eye-opening and the absence of awareness and voluntary movement [1]. VS/UWS patients classically receive hydration and nutrition through an enteral feeding tube. Objective - Methods : We retrospectively reviewed the clinical information of 65 VS/UWS patients (aged 45±12; range 16-85 years) evaluated at the CHU hospital of liege searching for mention of oral feeding. VS/UWS diagnosis was made after repeated behavioral assessments using the standardized coma recovery scale–revised (CRS-R, [2]) in association with complementary evaluations using neuroimaging techniques. Results : Of the 65 VS/UWS patients, two could resume oral feeding (3%). One could achieve full oral feeding and the other had oral feeding in addition to gastrostomy feeding. Neuroimaging evaluations showed in both patients a massive decrease in the spontaneous brain activity and its functional connectivity (using functional magnetic resonance imaging), bilateral cerebral cortex hypometabolism and preserved metabolism in the brainstem and cerebellum (using positron emission tomography). Discussion – Conclusion – Clinical message : oral feeding is rare in VS/UWS patients (3% in our cohort). Based on neuroimaging results, this behaviour does not seem to be incompatible with the diagnosis of VS/UWS but the neuromecanistic root, which allows this behavior, still needs to be elucidate. This study also emphasizes the importance of assess and manage deglutition in patients with altered state of consciousness regardless of their level of consciousness. Tactile oro-facial stimulation, manual therapy, taste stimulation and therapeutic feeding can be another “gateway” to interact with these patients and improve their quality of life.
Research center :
Giga-Coma Science
Disciplines :
Neurology
Author, co-author :
MELOTTE, Evelyne ;  Centre Hospitalier Universitaire de Liège - CHU > Service de médecine de l'appareil locomoteur
MAUDOUX, Audrey ;  Centre Hospitalier Universitaire de Liège - CHU > Service d'ORL, d'audiophonologie et de chir. cervico-faciale
DELHALLE, Sabrina ;  Centre Hospitalier Universitaire de Liège - CHU > Service d'ORL, d'audiophonologie et de chir. cervico-faciale
Martial, Charlotte  ;  Université de Liège - ULiège > GIGA : Coma Group
Antonopoulos, Georgios ;  Université de Liège - ULiège > GIGA : Coma Group
Larroque, Stephen Karl  ;  Université de Liège - ULiège > GIGA : Coma Group
Wannez, Sarah 
FAYMONVILLE, Marie-Elisabeth ;  Centre Hospitalier Universitaire de Liège - CHU > Service d'algologie - soins palliatifs
KAUX, Jean-François  ;  Centre Hospitalier Universitaire de Liège - CHU > Service de médecine de l'appareil locomoteur
LAUREYS, Steven  ;  Centre Hospitalier Universitaire de Liège - CHU > Service de neurologie
Gosseries, Olivia  ;  Université de Liège - ULiège > Centre de recherches du cyclotron
VANHAUDENHUYSE, Audrey  ;  Centre Hospitalier Universitaire de Liège - CHU > Service d'algologie - soins palliatifs
Language :
English
Title :
Is oral feeding compatible with an unresponsive wakefulness syndrome?
Alternative titles :
[fr] Une alimentation orale est-elle compatible avec le diagnostic de syndrome d'éveil-non-répondant ?
Publication date :
January 2018
Event name :
Joint Congress of the DCRM, BNF-PRM and RBSPRM 2017
Event organizer :
DCRM, BNF-PRM and RBSPRM
Event place :
Maastricht, Netherlands
Event date :
9-10 December 2017
Audience :
International
Peer reviewed :
Peer reviewed
Available on ORBi :
since 22 November 2017

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