Disorders Of Consciousness

This revised and expanded second edition discusses the assessment and treatment of patients recovering from coma and disorders of consciousness. Besides diagnostic, prognostic and ethical issues, this book describes well-established techniques and procedures, and also techniques under development. New chapters include consciousness theories, issues relating to long-term care, and neuromodulation treatments. Coma and Disorders of Consciousness, Second Edition is a comprehensive review of the field for clinicians and researchers, regardless of whether they are already familiar with the difficult but exciting field of disorders of consciousness.

This open access book focuses on practical clinical problems that are frequently encountered in stroke rehabilitation. Consequences of diseases, e.g. impairments and activity limitations, are addressed in rehabilitation with the overall goal to reduce disability and promote participation. Based on the available best external evidence, clinical pathways are described for stroke rehabilitation bridging the gap between clinical evidence and clinical decision-making. The clinical pathways answer the questions which rehabilitation treatment options are beneficial to overcome specific impairment constellations and activity limitations and are well acceptable to stroke survivors, as well as when and in which settings to provide rehabilitation over the course of recovery post stroke. Each chapter starts with a description of the clinical problem encountered. This is followed by a systematic, but concise review of the evidence (RCTs, systematic reviews and meta-analyses) that is relevant for clinical decision-making, and comments on assessment, therapy (training, technology, medication), and the use of technical aids as appropriate. Based on these summaries, clinical algorithms / pathways are provided and the main clinical-decision situations are portrayed. The book is invaluable for all neurorehabilitation team members, clinicians, nurses, and therapists in neurology, physical medicine and rehabilitation, and related fields. It is a World Federation for NeuroRehabilitation (WFNR) educational initiative, bridging the gap between the rapidly expanding clinical research in stroke rehabilitation and clinical practice across societies and continents. It can be used for both clinical decision-making for individuals and as well as clinical background knowledge for stroke rehabilitation service development initiatives.

Plum and Posner's Diagnosis and Treatment of Stupor and Coma, 5th edition, is a major update of the classic work on diagnosing the cause of coma, with the addition of completely new sections on treatment of comatose patients, by Dr. Jan Claassen, the Director of the Neuro-ICU at Columbia New York Presbyterian Hospital. The first chapter of the book provides an up-to-date review on the brain mechanisms that maintain a conscious state in humans, and how lesions that damage these mechanisms cause loss of consciousness or coma. The second chapter reviews the neurological examination of the comatose patient, which provides the basis for determining whether the patient is suffering from a structural brain injury causing the coma, or from a metabolic disorder of consciousness. The third and fourth chapters review the pathophysiology of structural lesions causing coma, and the specific disease states that result in coma. Chapter five is a comprehensive treatment of the many causes of metabolic coma. Chapter 6 review psychiatric causes of unresponsiveness and how to identify and treat them. Chapters 7 and 8 review the overall emergency treatment of comatose patients, followed by the treatment of specific causes of coma. Chapter 9 examines the long term outcomes of coma, including the minimally conscious state and the persistent vegetative state, and how they can be distinguished, and their implications for eventual useful recovery. Chapter 10 reviews the topic of brain death and the standards for examination of a patient that are required to make the determination of brain death. The final chapter 11 is by J.J. Fins, a medical ethicist who was invited by the other authors to write an essay on the ethics of diagnosis and treatment of patients who, by definition, have no way to approve of or communicate about their wishes. While providing detailed background for neurological and neurosurgical specialists, the practical nature of the material in this book has found its greatest use among Internists, Emergency Medicine, and Intensive Care specialists, who deal with comatose patients frequently, but who may not have had extensive neurological training.

The second edition of The Neurology of Consciousness is a comprehensive update of this ground-breaking work on human consciousness, the first book in this area to summarize the neuroanatomical and functional underpinnings of consciousness by emphasizing a lesional approach offered by the study of neurological patients. Since the publication of the first edition in 2009, new methodologies have made consciousness much more accessible scientifically, and, in particular, the study of disorders, disruptions, and disturbances of consciousness has added tremendously to our understanding of the biological basis of human consciousness. The publication of a new edition is both critical and timely for continued understanding of the field of consciousness. In this critical and timely update, revised and new contributions by internationally renowned researchers—edited by the leaders in the field of consciousness research—provide a unique and comprehensive focus on human consciousness. The new edition of The Neurobiology of Consciousness will continue to be an indispensable resource for researchers and students working on the cognitive neuroscience of consciousness and related disorders, as well as for neuroscientists, psychologists, psychiatrists, and neurologists contemplating consciousness as one of the philosophical, ethical, sociological, political, and religious questions of our time. New chapters on the neuroanatomical basis of consciousness and short-term memory, and expanded coverage of comas and neuroethics, including the ethics of brain death The first comprehensive, authoritative collection to describe disorders of consciousness and how they are used to study and understand the neural correlates of conscious perception in humans. Includes both revised and new chapters from the top international researchers in the field, including Christof Koch, Marcus Raichle, Nicholas Schiff, Joseph Fins, and Michael Gazzaniga

An essential, up-to-date and evidence-based revision guide designed in the style of the Final FFICM structured oral examination.

"Acute neurologic diseases encompass a wide spectrum of medical illnesses with neurological manifestations which require rapid clinical, paraclinical and laboratory evaluation as patients are evaluated in the emergency department or acute care clinics. In the last decade, imaging has assumed far greater importance in the initial assessment of these patients, and is responsible for much of the cost and resources in the early, critical evaluation. However the optimal approach to utilization of imaging for thorough, yet efficient and cost-responsible care remains poorly defined for many acute neurologic presentations"--Provided by publisher.

This book provides up-to-date information on all aspects of brain function and responsiveness in patients with severe disorders of consciousness. Topics considered include the mechanisms and measures of consciousness; perfusional, metabolic, and fMRI markers of responsiveness; responsiveness to pain; the role of brain–computer interface techniques; electrophysiology; cortical excitability; autonomic responsiveness; the natural history of vegetative and minimally conscious states; and prediction of outcome. Brain neuroimaging has documented residual responsiveness in the vegetative state. The scientific impact of this seminal evidence has generated a schism between neuroscience and the clinical criteria defining consciousness and responsiveness. Our current understanding of human consciousness must be reconsidered also in view of the emotional impact on the public and the far-reaching implications for diagnosis, prognosis, medical treatment, human costs, medical and individual responsibility, logistics, healthcare, ethics, etc. It is hoped that this book will help to bridge the gap between neuroscience and clinical routine.