title: Clinical diagnosis of prolonged states of impaired consciousness in adults.
abstract: A prolonged state of impaired consciousness is a devastating consequence of severe structural brain injury but fortunately is uncommon. Patients may be diagnosed as being in a persistent vegetative state, having akinetic mutism, or being in a minimally conscious state. These conditions can be distinguished from each other by a comprehensive clinical neurologic examination. Recovery is determined by age, cause, and time in such state. For patients diagnosed as being in a permanent (irreversible) vegetative state, hope for a clinically meaningful recovery is unrealistic after 1 year. Prolonged survival is possible only with meticulous care and aggressive medical intervention to prevent and treat systemic complications.
authors.affiliation: Department of Neurology and Division of Critical Care Neurology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. wijde@mayo.edu
authors.forename: Eelco F M
authors.initials: EF
authors.lastname: Wijdicks
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Cranford
mesh_terms: D000328:Adult; D003244:Consciousness Disorders / Q000145:classification / Q000175:diagnosis / Q000473:pathology; D004569:Electroencephalography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018458:Persistent Vegetative State / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D049268:Positron-Emission Tomography; D012720:Severity of Illness Index