Skip to main content

Consciousness in congenitally decorticate children: developmental vegetative state as self-fulfilling prophecy

  • D Alan Shewmon (a1), Gregory L Holmes (a2) and Paul A Byrne (a3)
    • Published online: 01 June 1999

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.

Corresponding author
Pediatric Neurology, UCLA Medical Center , MDCC 22-474, PO Box 951752, Los Angeles, CA 90095-1752, USA. E-mail:
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Developmental Medicine and Child Neurology
  • ISSN: 0012-1622
  • EISSN: 1469-8749
  • URL: /core/journals/developmental-medicine-and-child-neurology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed