Disorders of Consciousness

Excerpt

Disorders of Consciousness are a big challenge for the entire process of rehabilitation: assessment, diagnosis, pharmacological, and rehabilitation programs, including conventional treatments and the use of new technologies.

Causes of Disorders of Consciousness may vary from stroke to traumatic brain injury to post-anoxic or metabolic brain damage; but all Disorders of Consciousness are in fact a wide spectrum of clinical syndromes from vegetative state (recently named unresponsive wakefulness syndrome) to minimally conscious state and they may be a transitory event as well as persistent conditions.

The most correct diagnosis possible is important for prognosis, adequate, and tailored rehabilitation planning. We primarily consider the current available evidences on behavioral scales for the assessment of clinical presentation of Disorders of Consciousness because they still are the most important step in diagnosis of Disorders of Consciousness; then we describe the evidences on instrumental means for diagnosis, from EEG to fMRI and ERP.

The second part of the chapter is focused on recent rehabilitation evidences and recommendation on therapeutic interventions from early rehabilitation treatments to specific treatments for spasticity or to the use of new technologies such as repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and robotic devices.