title: Clinical management of the minimally conscious state.
abstract: The minimally conscious state (MCS) was defined as a disorder of consciousness (DoC) distinct from the vegetative state more than a decade ago. While this condition has become widely recognized, there are still no guidelines to steer the approach to assessment and treatment. The development of evidence-based practice guidelines for MCS has been hampered by ambiguity around the concept of consciousness, the lack of accurate methods of assessment, and the dearth of well-designed clinical trials. This chapter provides a critical review of existing assessment procedures, critically reviews available treatment options and identifies knowledge gaps. We close with practice-based recommendations for a rational approach to clinical management of this challenging population.
authors.affiliation: Park Terrace Care Center, Rego Park, NY, USA.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Rosenbaum
authors.affiliation: Department of Physical Medicine and Rehabilitation, Harvard Medical School and Spaulding Rehabilitation Hospital, Boston, MA, USA. Electronic address: jgiacino@partners.org.
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Giacino
mesh_terms: D019468:Disease Management; D006801:Humans; D018458:Persistent Vegetative State / Q000175:diagnosis* / Q000628:therapy*; D017410:Practice Guidelines as Topic
keywords: assessment; brain injury; diagnosis; minimally conscious state; rehabilitation