Otto Warmbier, a 22-year-old college student from Ohio, died Monday after returning home from North Korea in a coma.
Warmbier, who was held in custody for 18 months, was accused of taking a propaganda poster from a Pyongyang hotel. He was sentenced to 15 years of hard labor in prison. North Korean officials said he was given a sleeping pill after suffering from botulism – a type of food poisoning – which resulted in his coma.
However, doctors in the United States found no evidence of food poisoning while examining Warmbier upon his return. Instead, doctors said he suffered from Unresponsive Wakefulness Syndrome.
Here’s an overview of what Unresponsive Wakefulness Syndrome is and how to identify it in a patient.
1. What is Unresponsive Wakefulness Syndrome?
Unresponsive Wakefulness Syndrome (UWS), according to the National Institutes of Health, is when a person is in a vegetative state without signs of awareness. A patient’s eyes might be in a fixed position, track moving objects or move in an unsynchronized manner. UWS patients do not respond to sound, hunger or pain and lack motor responses. They breathe on their own and maintain a regular heartbeat.
2. What caused Warmbier’s UWS?
Dr. Daniel Kanter, professor of neurology and director of the Neurocritical Care Program at the University of Cincinnati Medical Center, told CNN that Warmbier’s MRI scan showed extensive loss of brain tissue. Dr. Kanter said Warmbier’s brain injury is seen in cardiopulmonary arrest patients, which occurs during heart or lung malfunctions. As a result, oxygen is prevented from reaching the brain, causing brain tissue to die. Dr. Daniel Laskowitz, professor of neurology at Duke University, told NBC News that Warmbier’s condition could have suddenly deteriorated due to an infection or a blood clot. It’s currently unclear what specific chain of events occurred to result in Warmbier’s death. The coroner’s office in Ohio is investigating his cause of death.
3. How is UWS diagnosed?
A neurologist will be able to diagnose whether a patient has UWS. The neurologist will look at patients for a lack of awareness of their environment and their self. A UWS patient will also lack response to sight, sound, touch or pain. A neurologist will also look for the absence of language and bowel and bladder control.
4. Can you treat UWS?
UWS patients require constant monitoring and assistance. The Coma Recovery Scale evaluates and measures signs of progress, improvement or deterioration. However, there’s no current treatment for UWS. Instead, patients are assisted with feeding, hydration, hygiene, movement and physical therapy to prevent blood clots or skin ulcers.
5. What are the chances of recovery for UWS patients?
If diagnosed with UWS, some patients can emerge from the vegetative state within weeks. Others may improve gradually or can stay in a state of impaired consciousness for years. In a worst case scenario, patients never regain consciousness. The chances of recovery are also dependent on the extent of the brain injury and the patient’s age.
