Are You There?The Growing Need to Get the Right Diagnosis in Disorder of Consciousness

Michele Torrisi, Adriana Piccolo, Rosaria De Luca, Matteo Berenati, Antonella Olivo, Giuseppa Maresca, Antonino Naro, Rocco Salvatore Calabrò

Research output: Contribution to journalArticle

Abstract

Disorder of consciousness (DOC) can be either an acute and reversible condition or a chronic condition, including vegetative state or minimally conscious state. Herein, we describe a patient who has unexpectedly recovered consciousness after being in a misdiagnosed vegetative state for a long period. A 63-year-old woman was admitted to our rehabilitation center in vegetative state (Coma Recovery Scale-Revised score, 6) and treated with a standard rehabilitation program, including physical therapy and multisensory stimulation, besides psychoactive drugs. After 26 months of such training, she progressively presented with unexpected signs of awareness. Thus, she was submitted to an intensive cognitive rehabilitation with a significant improvement of her performance (Coma Recovery Scale-Revised score, 19). With this report, we want to underline that the early use of paraclinical methods, including neuroimaging and neurophysiological paradigms, is mandatory in DOC to reach a more accurate diagnosis and perform the most appropriate neurorehabilitation. Moreover, diagnosis of functional locked-in syndrome should be considered because some patients with DOC may have covert awareness with the impossibility to display consistent and reproducible behaviors due to a "motor-cognitive dissociation."

Original languageEnglish
Pages (from-to)107-110
Number of pages4
JournalJournal of Neuroscience Nursing
Volume50
Issue number2
DOIs
Publication statusPublished - Apr 2018

Keywords

  • Adult
  • Awareness
  • Brain Injuries/complications
  • Coma
  • Consciousness Disorders/diagnosis
  • Female
  • Humans
  • Middle Aged
  • Persistent Vegetative State/diagnosis
  • Recovery of Function
  • Rehabilitation Centers/statistics & numerical data

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