Vegetative state: efforts to curb misdiagnosis.

Media reports on the case of Rom Houben have constituted a new reminder of the risks of misdiagnosis with cases with apparent vegetative state, particularly when following the clinical consensus of the care team as diagnostic criterion. Systematic use of behavioral and non-behavioral assessment strategies (e.g., behavioral scales, event-related potentials, and neuro-imaging) may help reduce the aforementioned risks. A new learning assessment strategy could also be considered part of the assessment to extend the evaluation process. Signs of learning might be viewed as forms of concrete knowledge representing a basic level of non-reflective consciousness.