title: Moving into the wide clinical spectrum of consciousness disorders: Pearls, perils and pitfalls.
abstract: The last few years have been characterized by a growing interest of the medical and scientific world for the field of consciousness and its related disorders. Medically speaking, consciousness can be defined as the state of awareness of self and environment and the alertness to external stimulation, besides responsiveness to inner need. Transient loss of consciousness can be due to alterations in cerebral blood flow leading to fainting or syncope, migraine, metabolic dysfunctions, unexpected intracranial pressure increases, epileptic seizures, and sleep disorders. Chronic disorders of consciousness are a tragic success of high-technology treatment, in an attempt to maintain or reestablish brain function, which is to be considered as the main goal of therapeutics. Management of vegetative or a minimally conscious state individuals involves charily getting the right diagnosis with an evidence-based prognosis, also taking into account the medical, ethical, and legal key factors of the ideal treatment. This paper is aimed at exploring the wide spectrum of consciousness disorders and their clinical differential diagnosis, with particular regards to those with a negative impact on patient and their caregiver quality of life, including epilepsy, sleep disorders, and vegetative/minimally conscious state.
authors.affiliation: IRCCS Neurolesi "Bonino Pulejo" Center, Messina, Italy. Electronic address: salbro77@tiscali.it.
authors.forename: Rocco Salvatore
authors.initials: RS
authors.lastname: Calabrò
authors.affiliation: IRCCS Neurolesi "Bonino Pulejo" Center, Messina, Italy; Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
authors.forename: Demetrio
authors.initials: D
authors.lastname: Milardi
authors.affiliation: IRCCS Neurolesi "Bonino Pulejo" Center, Messina, Italy; Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cacciola
authors.affiliation: IRCCS Neurolesi "Bonino Pulejo" Center, Messina, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Marra
authors.affiliation: IRCCS Neurolesi "Bonino Pulejo" Center, Messina, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Digangi
authors.affiliation: Neurologic Unit, University Polyclinic, Messina, Italy.
authors.forename: Carmela
authors.initials: C
authors.lastname: Casella
authors.affiliation: IRCCS Neurolesi "Bonino Pulejo" Center, Messina, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Manuli
authors.affiliation: IRCCS Neurolesi "Bonino Pulejo" Center, Messina, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: De Luca
authors.affiliation: Neurologic Unit, University Polyclinic, Messina, Italy.
authors.forename: Rosalia
authors.initials: R
authors.lastname: Silvestri
authors.affiliation: IRCCS Neurolesi "Bonino Pulejo" Center, Messina, Italy.
authors.forename: Placido
authors.initials: P
authors.lastname: Bramanti
mesh_terms: D003243:Consciousness; D003244:Consciousness Disorders / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D018458:Persistent Vegetative State / Q000175:diagnosis* / Q000628:therapy; D011379:Prognosis; D011788:Quality of Life
keywords: Coma; Consciousness; Minimally conscious state; Sleep; Vegetative state