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Consciousness in congenitally decorticate children: developmental vegetative state as self‐fulfilling prophecy
Author(s) -
Shewmon D Alan,
Holmes Gregory L,
Byrne Paul A
Publication year - 1999
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.1999.tb00621.x
Subject(s) - psychology , consciousness , brainstem , neuroplasticity , minimally conscious state , neuroscience , developmental psychology , cognitive psychology
According to traditional neurophysiological theory, consciousness requires neocortical functioning, and children born without cerebral hemispheres necessarily remain indefinitely in a developmental vegetative state. Four children between 5 and 17 years old are reported with congenital brain malformations involving total or near‐total absence of cerebral cortex but who, nevertheless, possessed discriminative awareness: for example, distinguishing familiar from unfamiliar people and environments, social interaction, functional vision, orienting, musical preferences, appropriate affective responses, and associative learning. These abilities may reflect‘vertical’plasticity of brainstem and diencephalic structures. The relative rarity of manifest consciousness in congenitally decorticate children could be due largely to an inherent tendency of the label‘developmental vegetative state’to become a self‐fulfilling prophecy.