Sub signum coma –  cur­rent view of chronic disorders of consciousnes­s

Authors: A. Škutchanová 1;  E. Kantorová 2;  E. Kurča 2
Authors‘ workplace: Klinika intenzívnej medicíny a anesteziológie JLF UK a UN Martin 1;  Neurologická klinika JLF UK a UN Martin 2
Published in: Cesk Slov Neurol N 2019; 82(1): 19-24
Category: Review Article


Chronic disorders of consciousness are a modern phenomenon. Recognis­­ing first behavioural signs of contact with the patient‘s environment after coma plays a key role in the patient`s access to extended treatment and rehabilitation, as well as in establish­­ing an ef­fective contact with the environment; it is also considered to be an important prognostic sign. Cur­rent western terms in comparison with traditional definition of apal­lic syndrome or the term coma vigile are more descriptive and precise. In recent years, new methods of as­ses­sment, which enable more exact evaluation of brain disorders were established. However, most of them remain experimental and lack clinical availability, which favours clinical test­­ing us­­ing daily objects. Behavioural response as­ses­sment is the standard to compare results obtained with other methods of as­ses­sment. In our work, we present our view on our perception of a patient with a disorder of consciousness and an overview of cur­rent options in identify­­ing the underly­­ing organic substrate.

Key words:

chronic disorders of consciousness – state of minimal consciousness – vegetative state – wakefulness without answering – WS/UWS – MCS – apallic syndrome – coma vigile – diagnostics – behavioural correlate – examination methods

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


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