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  America
American Man Speaks after 19 Years in Coma

42-year-old Terry Wallis regained his consciousness after 19 years in coma in in Arkansas in US

When Terry Wallis's pick-up truck crashed through the barrier on a mountain road, plunging into a dry river bed, doctors gave the teenager little chance of survival.

The accident, which killed one of his companions, left him with severe head injuries, in a coma and paralysed from the neck down.

That was in 1984. Mr Wallis, a farmer's son from Arkansas, remained in a minimally conscious state, medically known as MCS, and outwardly unresponsive for years, until doctors witnessed what they have described as a medical miracle.

In 2003, after 19 years, Mr Wallis called out to his mother and asked for a can of Pepsi.

Scientists from Cornell University in New York believe a slow process of brain repair and neural reconnection prompted Mr Wallis's recovery.

A study of the structure of his brain has revealed that the neuronal cells in relatively undamaged areas have grown important new connections over a period of years.

Scientists writing in this month's Journal of Clinical Investigation describe the process, known as axonal regrowth, and how it might be encouraged in other MCS sufferers.

Henning Voss and colleagues from Cornell compared the structure and function of Mr Wallis's brain after his recovery with that of 20 healthy individuals and an MCS patient who showed no recovery after six years. The authors suggest the axonal regrowth may be the result of the brain trying to re-establish connections that would allow for the resumption of functions such as motor control and speech.

Mr Wallis, 42, has undergone a rehabilitation process that has included his reintroduction to his wife and the 19-year-old daughter whom he last saw as a baby.

The recovery has prompted intense debate about patients with similar medical conditions.

In the first full scientific assessment of Mr Wallis's recovery, Dr Voss and his co-authors note that he initially remained in a coma for about a fortnight, then recovered to a level of function consistent with MCS after several months.

"Although gradual improvements in responsiveness were noted over an ensuing 19-year period, the patient was unable to communicate using gesture or verbal output," they say.

"Limited head nodding and grunting were only inconsistently present."

Eight months before the team's first evaluation, Mr Wallis spoke his first word - "Mum" - followed by a recovery over several days of "increasingly ... reliable communication." Further examination revealed that Mr Wallis believed it was still 1984.

Steven Laureys, from the University of Liege, said the case underlined the importance of therapy for patients who might be candidates for such recovery.

"Chronically unconscious or minimally conscious patients represent unique problems for diagnosis, prognosis, treatment and everyday management," he said.

The results were an important addition to the understanding of severely brain-damaged patients.

Jerry Wallis, Mr Wallis's father, said his son's short-term memory remained impaired, but added: "He seems almost exactly like his old self. And he very often tells us how glad he is to be alive."

Cases of Long-Delayed Recoveries

Louis Viljoen, a South African man left in a permanent vegetative state by a road accident, has regained a temporary ability to talk when taking the sleeping pill Stilnoct. Mr Viljoen had not spoken for three years but can now have basic conversations because of the drug

Donald Herbert, a firefighter from New York, went into a three-month coma in 1995 after a burning roof buried him under debris. After little communication for almost ten years, Mr Herbery suddenly announced to nurses: "I want to talk to my wife"

Gary Dockery, a Tennessee police officer who was brain-damaged in a 1988 shooting, began speaking to his family one day in 1996, telling jokes and recounting annual winter camping trips. However, after 18 hours he returned to a silent state and did not show further conversational skills




 

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