Sleeping beauty may not have been such an exceptional girl, after all. Italian doctors were shocked to see a patient, who had been in coma for over a year, unexpectedly awaken and regain full consciousness after receiving midazolam, a sedative with the benzodiazepine family of drugs. A recently published report describes the strange case study.

Identified by the initials “SV,” the 43-year-old male patient suffered a trauma to his face and skull as a result of a car accident. Admitted to the hospital, he scored a "four" on the Glasgow Coma Scale, where "three" indicates deep unconsciousness; his CT scan showed hemorrhagic lesions in his brain. Although dependent in all life activity, he was discharged from the hospital and attended to by his family while doctors continued to monitor his health.

Switched Drugs

During a routine brain scan, doctors prescribed the sedative midazolam, instead of propofol as SV had been given in the past. All at once, everything changed. “Surprisingly SV began to interact with the anesthetist and soon after with his parents,” wrote the researchers in their published study. They noted, “He was able to answer with simple sentences to specific questions. He could pronounce his own name and the name of simple objects brought to his sight.”

His doctors tested in him various ways, asking whether he understood simple sentences, requesting he read simple object nouns and then progressing to simple sentences, such as “close your eyes.” The he remained somewhat disoriented, SV was able to recognize his relatives, recall the names of two of his grandchildren, and even compute simple subtractions. "He talked by cellphone with his aunt and congratulated his brother when he was informed of his graduation," the authors of the study wrote.

Sadly, this beautiful awakening lasted only two hours, after which SV returned to his previous state of unconsciousness. Though doctors confirmed his reaction was to midazolam, SV could not maintain consciousness. His disappointed doctors hypothesize that SV may have another disorder, which produces minor seizures, and this is both why his response occurred and why he has returned to his previous state. The researchers continue to study the scans taken before, during, and after SV received the drug in an effort to see which parts of his brain became altered by the drug. The surprising and sad story of SV nonetheless suggests the possibility of treating coma patients with midazolam or similar drugs.

Source: Carboncini MC, Piarulli A, Virgillito A, et al. A case of post-traumatic minimally conscious state reversed by midazolam: Clinical aspects and neurophysiological correlates. Restorative Neurology and Neuroscience. 2014.