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Background  Some patients  awaken  from coma (that is, open the eyes) but remain unresponsive (that is, only showing reflex movements without response to command). This syndrome has been coined  vegetative state . We here present a new name for this challenging neurological condition:  unresponsive wakefulness syndrome  (abbreviated UWS).    Discussion  Many clinicians feel uncomfortable when referring to patients as  vegetative . Indeed, to most of the lay public and media  vegetative state  has a pejorative connotation and seems inappropriately to refer to these patients as being  vegetable-like . Some political and religious groups have hence felt the need to emphasize these vulnerable patients' rights as human beings. Moreover, since its first description over 35 years ago, an increasing number of functional neuroimaging and cognitive evoked potential studies have shown that physicians should be cautious to make strong claims about awareness in some patients without behavioral responses to command. Given these concerns regarding the negative associations intrinsic to the term  vegetative state  as well as the diagnostic errors and their potential effect on the treatment and care for these patients (who sometimes never recover behavioral signs of consciousness but often recover to what was recently coined a  minimally conscious state ) we here propose to replace the name.    Conclusion  Since after 35 years the medical community has been unsuccessful in changing the pejorative image associated with the words  vegetative state , we think it would be better to change the term itself. We here offer physicians the possibility to refer to this condition as  unresponsive wakefulness syndrome  or UWS. As this neutral descriptive term indicates, it refers to patients showing a number of clinical signs (hence  syndrome ) of unresponsiveness (that is, without response to commands) in the presence of wakefulness (that is, eye opening).

Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome