Peripheral Causes of Cognitive Motor Dissociation in Patients With Vegetative or Minimally Conscious State—Reply

In Reply We thank Latronico for the comments regarding our article.¹ Latronico proposed that peripheral nervous system and muscle pathology² may have contributed to the lack of behavioral responses exhibited by our patient. As mentioned in our Discussion section, Shea and Bayne³ had previously argued a similar peripheral explanation for the absence of overt motor behavior in patients with preserved covert motor behavior.⁴ In vegetative and minimally conscious patients, peripheral damage is most commonly related to motor axonal neuropathy,⁵ which, as Latronico points out, is a major cause of paralysis.²