The minimally conscious state: definition and diagnostic criteria
- PMID: 11839831
- DOI: 10.1212/wnl.58.3.349
The minimally conscious state: definition and diagnostic criteria
Abstract
Objective: To establish consensus recommendations among health care specialties for defining and establishing diagnostic criteria for the minimally conscious state (MCS).
Background: There is a subgroup of patients with severe alteration in consciousness who do not meet diagnostic criteria for coma or the vegetative state (VS). These patients demonstrate inconsistent but discernible evidence of consciousness. It is important to distinguish patients in MCS from those in coma and VS because preliminary findings suggest that there are meaningful differences in outcome.
Methods: An evidence-based literature review of disorders of consciousness was completed to define MCS, develop diagnostic criteria for entry into MCS, and identify markers for emergence to higher levels of cognitive function.
Results: There were insufficient data to establish evidence-based guidelines for diagnosis, prognosis, and management of MCS. Therefore, a consensus-based case definition with behaviorally referenced diagnostic criteria was formulated to facilitate future empirical investigation.
Conclusions: MCS is characterized by inconsistent but clearly discernible behavioral evidence of consciousness and can be distinguished from coma and VS by documenting the presence of specific behavioral features not found in either of these conditions. Patients may evolve to MCS from coma or VS after acute brain injury. MCS may also result from degenerative or congenital nervous system disorders. This condition is often transient but may also exist as a permanent outcome. Defining MCS should promote further research on its epidemiology, neuropathology, natural history, and management.
Comment in
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Questions remaining about the minimally conscious state.Neurology. 2002 Feb 12;58(3):337-8. doi: 10.1212/wnl.58.3.337. Neurology. 2002. PMID: 11839827 Review. No abstract available.
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The minimally conscious state: definition and diagnostic criteria.Neurology. 2002 Feb 12;58(3):506; author reply, 506-7. Neurology. 2002. PMID: 11839872 No abstract available.
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Effect of L-carnitine treatment for valproate-induced hepatotoxicity.Neurology. 2002 Feb 12;58(3):507-8. doi: 10.1212/wnl.58.3.507. Neurology. 2002. PMID: 11839873 No abstract available.
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The minimally conscious state: definition and diagnostic criteria.Neurology. 2002 Feb 12;58(3):506; author reply, 506-7. Neurology. 2002. PMID: 11887790 No abstract available.
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The minimally conscious state: definition and diagnostic criteria.Neurology. 2002 Nov 12;59(9):1473; author reply 1473-4. Neurology. 2002. PMID: 12427915 No abstract available.
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The minimally conscious state: definition and diagnostic criteria.Neurology. 2002 Nov 12;59(9):1473; author reply 1473-4. Neurology. 2002. PMID: 12434798 No abstract available.
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The minimally conscious state: definition and diagnostic criteria.Neurology. 2002 Nov 12;59(9):1473; author reply 1473-4. Neurology. 2002. PMID: 12434799 No abstract available.
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