Navigation Links
Disorders of consciousness: How should clinicians respond to new therapeutic interventions?
Date:8/2/2012

New tools have confirmed high rates of misdiagnosis of patients with chronic disorders of consciousness, such as the vegetative state. An increasing number of patients' families wish to use these novel techniques for diagnosis, prognosis, and treatment. An international team of researchers, including Dr. ric Racine, researcher at the IRCM, analyzed the clinical, social and ethical issues that clinicians are now facing. Their article is published in the August edition of The Lancet Neurology, a renowned journal in the field of clinical neurology.

"Patients with disorders of consciousness have traditionally been regarded as unaware by definition, but findings from recent clinical studies have revealed astounding cases of awareness despite clinical unresponsiveness," explains Dr. Racine, a Montral neuroethics specialist.

Severe brain injury can leave patients with chronic disorders of consciousness, which are medical conditions that inhibit consciousness. Patients thus have severe motor and cognitive impairments, remain fully dependent on others for all activities of daily living, and have no or very limited means to functionally communicate their thoughts or wishes, depending on their state.

Even with a careful neurological assessment of these types of disorders, some signs of awareness can elude the clinician because the clinical diagnosis relies on the observation of motor signs of awareness, which can be very subtle and fluctuate over time.

New technological developments can now measure brain function both in resting states and in response to simple commands, independent of muscle function, which could help establish a more accurate diagnosis. As a result, diagnostic classifications have been revised and prognostic knowledge is improving. For the first time, therapeutic studies have recently shown the effects of treatment on the improvement of patient responsiveness.

"The medical decision to stop or continue rehabilitation, or to transfer a patient to a long-term care facility can be hard to accept for the family, but one of the most difficult treatment decisions by family members remains whether to continue life-sustaining therapy or to discontinue it and only provide palliative care," says Dr. Racine.

Media coverage of disorders of consciousness has increased and information on the subject is increasingly available to the public. Clinicians such as neurologists, rehabilitation specialists, family doctors, and nurses must answer more requests from patients' family members for novel diagnostic and therapeutic procedures.

"Clinicians therefore need to be prepared to discuss disorders of consciousness with ethical sensitivity, especially considering that the new procedures remain investigational," adds Dr. Racine. "They must be aware of the level of evidence supporting them and of the unavoidable ethical and social issues involved in responding to requests from patients' family members."


'/>"/>
Contact: Julie Langelier
julie.langelier@ircm.qc.ca
514-987-5555
Institut de recherches cliniques de Montreal
Source:Eurekalert

Related medicine news :

1. Life Transitions May Trigger Eating Disorders
2. LA BioMeds Dr. Patricia Dickson researching treatments for neurodegenerative disorders
3. Preteen Food Choices May Help Predict Eating Disorders Later
4. Elsevier, SVS announce 2013 launch of Journal of Vascular Surgery: Venous and Lymphatic Disorders
5. Snoring Isn't Sexy Member Dr. Mark Levy attends Academy of Clinical Sleep Disorders Disciplines Conference in Phoenix, Arizona
6. Eating Disorders Hitting Women Over 50, Study Finds
7. Bees shed light on human sweet perception and metabolic disorders
8. Childless women with fertility problems at higher risk of hospitalization for psychiatric disorders
9. Electrical brain stimulation can alleviate swallowing disorders after stroke
10. Mount Sinai finds common factors in autism spectrum disorders, schizophrenia, and bipolar disorder
11. Girls with eating disorders regain healthy fatty acid levels when their weight normalizes
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:1/24/2017)... ... , ... The results from the American Cancer Society’s newest report ... cancer patients: incidents of cancer is down as is the likelihood of prostate cancer ... has dropped from its peak of 215.1 in 1991 to 161.2 in 2014 (per ...
(Date:1/24/2017)... ... 2017 , ... A yellow fever outbreak in Brazil has infected over 100 ... primarily spread through contact with infected mosquitos. The outbreak has sparked increased concern about ... , According to multiple health organizations, the best way to prevent yellow fever is ...
(Date:1/24/2017)... ... January 24, 2017 , ... “Spiritual ... improve the connection with God. “Spiritual Vitamins: A Spiritual Energy Booster” is the ... Christian Faith Publishing, Mathai Yohannan’s new book engages the mind and spirit in ...
(Date:1/24/2017)... ... January 23, 2017 , ... CLICKco ... and espresso drink, announced its CLICK® Coffee Protein Drink is now available for ... Drink Mix has become popular among health-conscious consumers who love coffee but are ...
(Date:1/24/2017)... Dallas, Texas (PRWEB) , ... January 23, 2017 ... ... expanding its presence in Texas with the acquisitions of two personal care service ... (PAS), in Texas City, Texas, effective January 1, 2017. , Well regarded in ...
Breaking Medicine News(10 mins):
(Date:1/23/2017)... Calif. , Jan. 23, 2017  HOPE ... exclusive rights to develop and commercialize nuc ... Therapeutics, a Korean pharmaceutical company. ... DNA aptamer against surface nucleolin found on many ... gemcitabine. Unlike ADCs (antibody drug conjugates) or SMDCs ...
(Date:1/23/2017)... YORK , Jan. 23, 2017 Consolidated ... Partners and Driving the Stability Testing Outsourcing Market ... market addresses market sizing, emerging trends, and technologies, and ... market. The base year is 2015 and forecasts are ... is expected to grow at a CAGR of 9.4% ...
(Date:1/23/2017)... 2017 MouthWatch LLC announced today that its flagship ... the best intraoral camera on DentalCompare,s list of Top ... The #1 product was the CollaPlug Absorbable Collagen Wound ... was "…incredibly popular because it is by far the most ... sticker price, it doesn,t sacrifice quality imaging." ...
Breaking Medicine Technology: