Clinical Neurophysiology in the Prognostic and Diagnostic Evaluation of Disorders of Consciousness

Abstract

According to its neurophysiological function, a disorder of consciousness (DOC) is a long-lasting change in the consciousness state of a patient that can be categorized as a coma, vegetative state, locked-in syndrome, or minimally conscious state. Although recent advances in neuroimaging and electroencephalography may help us better understand the brain networks involved in states of awareness and consciousness, the pathophysiology of DOC remains poorly understood. The main objectives of DOC rehabilitation programs are to maintain live support, to reduce the likelihood of a comatose patient developing new medical conditions, and to provide the affected families with the relevant information to make informed choices as to whether to continue the live-supporting programs. Therapeutic interventions can include both pharmacologic and nonpharmacologic therapies although at present there are no definite medical treatments for people with DOC. This research investigates and recommends numerous diagnostic methods and treatments that can be used to identify cognitive and neurobiological impaired states of consciousness, including coma, persistent vegetative state (PVS), also referred to as "unresponsive wakefulness syndrome" and other severe forms of awareness impairments, often brought on by acute brain injury but also other toxic or metabolic causes.