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Sharon responds to stimuli, breathes on his own

JERUSALEM—Israeli Prime Minister Ariel Sharon showed the first tangible signs of improvement Monday—moving his right hand and right leg in response to pain stimulation, and sporadically breathing on his own—after doctors began reducing the medication that's kept him anesthetized and on a ventilator since his near-fatal stroke last week.

Doctors at Hadassah Ein Kerem Hospital, where Sharon has undergone three rounds of brain surgery since he had a massive cerebral hemorrhage last Wednesday, said the right-side movements and spontaneous respiration indicated that Sharon's brain stem was functioning. They cautioned, however, that it was too early to assess his chances for retaining cognitive abilities if he recovers.

Dr. Felix Umansky, the chief neurosurgeon who's treating Sharon, said the medical team would continue reducing the prime minister's sedatives over the next few days in the hope that he'd show a greater response to stimulation, including opening his eyes.

Outside medical experts who've been following the case through the media said that since Sharon had sustained most of the damage in the right hemisphere of his brain, he had a greater chance of regaining his speech and comprehension, which the left hemisphere controls.

"What you can say is he has an average recovery from the kind of event he went through," said Dr. Jean Sousteil, the deputy head of neurosurgery at Ramban Hospital in Haifa. "After such an episode, the first threat comes from the brain itself because of recurrent bleeding or edema," swelling caused by accumulating fluid. "If the patient passes through this, now he comes to the second part, which is whether or not he will regain consciousness and breathe spontaneously without a ventilator. ... This is the phase where (Sharon) is right now. It is certainly a good thing that he has passed the first stage, but he still has a long way to go."

Doctors said Sharon was still at risk of not surviving. If he does, it might be weeks before they can assess what kind of life he'd have. Eighty percent of a patient's recovery occurs in the first six to 12 weeks after such an episode, experts said.

Dr. Harry Rappaport, the director of neurosurgery at Rabin Medical Center in Petah-Tikva and a graduate of the University of Pennsylvania Medical School, said his clinic saw about two stroke cases a week at Sharon's severity level.

"In the short term, the mortality rate is over 50 percent. Morbidity, which means limitation of function, is practically universal. In the most optimistic scenario one would be left with a weakness of the left side of the body but be able to converse and understand," Rappaport said, adding that only about 10 percent of cases at Sharon's level of severity achieve that outcome.

While Sharon's illness has thrown Israel's political scene into limbo, there was some progress Monday on ensuring that Palestinian legislative elections take place as scheduled Jan. 25.

After barring Palestinian politicians from campaigning in mostly Palestinian East Jerusalem last week, Israeli officials said they'd allow any candidate who wasn't linked to the Islamic militant group Hamas, whose charter calls for Israel's destruction, to campaign in the city. It was the first indication that Israel may allow Palestinian voters to cast ballots in East Jerusalem, a step that Palestinian Authority President Mahmoud Abbas said was crucial to free and fair elections.

After delaying their trip to the region because of Sharon's illness, American envoys David C. Welch and Elliott Abrams are expected to arrive Wednesday to talk to both parties about resolving the east Jerusalem voting question.

While Abbas is under intense pressure from some members of his ruling Fatah Party to delay the elections because of concerns that Hamas will emerge as a powerful political force, American officials are urging the Palestinian leader to hold them as scheduled.

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(Matza reports for The Philadelphia Inquirer.)

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(c) 2006, Knight Ridder/Tribune Information Services.

GRAPHIC (from KRT Graphics, 202-383-6064): 20060109 Mideast leaders

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