Belgian Man Trapped In Coma For 23 Years Was Conscious Throughout

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Main Category: Neurology / Neuroscience
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Article Date: 24 Nov 2009 - 2:00 PST

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Rom Houben, a Belgian man whom doctors believed to have been in a coma for 23 years following a car crash in 1983, was conscious all the time: we know because Houben himself has told us, in several media interviews conducted over the last few days.

Doctors in Zolder, Belgium, had repeatedly diagnosed Houben using the internationally accepted Glasgow Coma Scale to assess his eye, verbal and motor responses. But each time he was incorrectly graded as being in a vegetative state, reported the Daily Mail.

It was only when Steven Laureys, a doctor and researcher at the University of Liège, scanned Houben's brain in 2006 and discovered it was still working, although his body was paralysed, that doctors began to realize he may be conscious.

Now 46, Houben told the BBC that he had to learn to be patient. He was very angry at first when he realized other people had an opinion of him that was rather pathetic, but he had to learn to be patient, he said.

Intense physiotherapy for the last three years has been helping him regain some movement, reports the Guardian.

Houben said he realized when he came round after his accident that his body was paralyzed, and while he could hear everything the doctors were saying, he couldn't communicate with them.

"I screamed, but there was nothing to hear," said Houben.

"I dreamed myself away," he added, using one finger on a computer touchscreen attached to his wheelchair. The computer is also fitted with a special device that allows him to read books while lying down, reported the Daily Mail.

Houben said he just spent the time dreaming of a better life.

"Frustration is too small a word to describe what I felt." he said.

Houben's paralysis was the result of his brain being starved of oxygen when his heart stopped for a few minutes.

A former engineering student who speaks four languages, Houben said he coped by meditating, according to a Guardian report.

He told his doctors that sometimes he was only his consciousness and "nothing else" as he travelled with his thoughts into the past or "into another existence".

When the doctors discovered he was not in a vegetative state, Houben described feeling reborn:

"It was my second birth," he said.

His mother, Fina Houben, said she always believed he could communicate. She told the BBC that her son was not depressed, "he is an optimist", she said, and "wants to get out of life what he can".

Laureys, who wrote up Houben's case as part of a study published in BMC Neurology earlier this year, said that advances in medicine had caught up with him, and that Houben was probably not the only case, suggesting there may be other people with "false coma" around the world lying in hospital beds desperate to communicate.

Laureys leads the Coma Science Group at the Cyclotron Research Center in Sart Tilman Liège University Hospital. He is also Clinical Professor and Senior Research Associate at the Belgian National Fund of Scientific Research (FNRS) and chair of the "European Neurological Society Subcommittee on Coma and disorders of consciousness".

When he did his MSc in Pharmaceutical Medicine in 1997, he studied pain and stroke using diffusion MRI and other methods, and a growing interest in functional neuroimaging led to a move to the Cyclotron Research Center at the University of Liège, Belgium, where he got his PhD and continued to specialize in residual brain function in coma, vegetative, minimally conscious and locked-in states.

In the paper Laureys and colleagues found that the rate of misdiagnosis of cases of vegetative state has not changed much in the last 15 years.

For the study, they compared consensus-based diagnoses of vegetative and minimally conscious states (VS and MCS) to those based on a well-established instrument that rates neurobehavioral characteristics called the JFK Coma Recovery Scale-Revised (CRS-R).

They found that in 44 patients diagnosed with VS based on the clinical consensus of the medical team, 18 (41 per cent) were found to be in MCS and 4 (10 per cent) had emerged from MCS, based on the CRS-R method.

They concluded that:

"Standardized neurobehavioral assessment is a more sensitive means of establishing differential diagnosis in patients with disorders of consciousness when compared to diagnoses determined by clinical consensus."

"Diagnostic accuracy of the vegetative and minimally conscious state: Clinical consensus versus standardized neurobehavioral assessment."
Schnakers C, Vanhaudenhuyse A, Giacino J, Ventura M, Boly M, Majerus S, Moonen G, Laureys S.
BMC Neurology 2009, 9:35 (21 July 2009).

Sources: Daily Mail, BBC News, Université de Liège, Guardian.

Written by: Catharine Paddock, PhD
Copyright: Medical News Today
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