A man in Italy who was in what doctors call a "minimally conscious state" for nearly two years unexpectedly regained full consciousness and the ability to talk, according to a new report of his case.
The man woke up after he was given a drug normally used as a sedative before surgery and other medical procedures, the case report showed. The 43-year-old man was admitted to a hospital after a car accident, and was in a coma for 40 days. The man awoke from the coma but remained in a "minimally conscious state," which means that although he remained largely unable to communicate or move, he was able to voluntarily open and close his eyes, and reach for and touch objects. He also had a sleep-wake cycle.
When he was discharged from the hospital 10 months later, he still did not talk or communicate with other people, nor did he respond to simple commands asking him to, for instance, close his eyes.
Over the next year, the man's cognitive ability started to decline, his movements became abnormally slow, and he began to engage in aimless, repetitive behaviours, such as clapping. But then, about two years after the accident, the man's doctors wanted to examine his brain using a CT scan. To do the scan, they gave the man a mild sedative called midazolam. A few minutes later, the man began to talk and interact with others.
"He talked by cell phone with his aunt and congratulated his brother when he was informed of his graduation; he recognized the road leading to his home,"
This is the first report of midazolam having an "awakening" effect, the researchers said.
However, the effect wore off after about two hours, and the man returned to his previous state, unresponsive to the environment, according to the study.
To see whether it was indeed the drug that caused the brief improvement in the man's condition, the researchers gave the man midazolam again. Several minutes following the administration, the patient began to interact with his brother and answered questions the researchers asked him. He was also able to calculate simple math problems, such as 100 minus 7, as well as read and understand simple sentences, such as "Close your eyes."