Current clinical approach to patients with disorders of consciousness

Abstract

In clinical practice, hospital admission of patients with altered level of consciousness, sleepy or in a non-responsive state is extremely common. This clinical condition requires an effective investigation and early treatment. Performing a focused and objective evaluation is critical, with quality history taking and physical examination capable to locate the lesion and define conducts. Imaging and laboratory exams have played an increasingly important role in supporting clinical research. In this review, the main types of changes in consciousness are discussed as well as the essential points that should be evaluated in the clinical management of these patients.

Adaptation of Evidence-based Clinical Practice Guidelines for Management of Altered Level of Consciousness in Children: An Emergency Guide

“…Concerning the neuroimaging the adapted guideline recommended to carry out emergency neuroimaging scan when the child is stable if the working diagnosis is unknown or possible intracranial abscess or the cause is unknown. In accordance with our recommendations for best practices, According to Amorim et al (2016) (18) , head tomography is required when there is a suspicion of an intracranial lesion and should be the first image evaluation ordered. Moore et al (19) further stated that MRI is not a standard evaluation performed in the emergency room.…”

Avaliação Do Estado Mental Do Paciente Na Sala De Emergência

“…A escala de coma de Glasgow é uma escala padronizada usada para analisar o nível de consciência projetada para pacientes com lesão traumática, mas também podem ser utilizadas na avaliação de qualquer distúrbio da consciência em fase aguda (AMORIM et al, 2016). A escala mede o grau de consciência em três categorias diferentes de funcionamento neurológico, que são abertura de olhos, resposta verbal e melhor resposta motora.…”

Presumed first episode of nonconvulsive status epilepticus as the cause of postoperative disorder of consciousness following the completion of general anesthesia: A case report

“…DOC can lead to irreversible sequelae if early intervention is not provided. Therefore, early diagnosis and treatment are of paramount importance 3 . Indeed, diagnosing DOC during the perioperative period can be challenging due to the effects of anesthesia.…”

“…Therefore, early diagnosis and treatment are of paramount importance. 3 Indeed, diagnosing DOC during the perioperative period can be challenging due to the effects of anesthesia. We encountered a patient who developed impaired consciousness after surgery, following awakening and extubation.…”