From unresponsive wakefulness to minimally conscious PLUS and：反应迟钝的觉醒到最小意识加.pdfVIP

J Neurol DOI 10.1007/s00415-011-6114-x MEDICAL PROGRESS IN THE JOURNAL OF NEUROLOGY From unresponsive wakefulness to minimally conscious PLUS and functional locked-in syndromes: recent advances in our understanding of disorders of consciousness • • ´ Marie-Aurelie Bruno Audrey Vanhaudenhuyse Aurore Thibaut • Gustave Moonen • Steven Laureys Received: 12 May 2011 / Revised: 16 May 2011 / Accepted: 18 May 2011 Springer-Verlag 2011 Abstract Functional neuroimaging and electrophysiol- syndrome. An improved assessment of brain function in ogy studies are changing our understanding of patients with coma and related states is not only changing nosology and coma and related states. Some severely brain damaged medical care but also offers a better-documented diagnosis patients may show residual cortical processing in the and prognosis and helps to further identify the neural absence of behavioural signs of consciousness. Given these correlates of human consciousness. new findings, the diagnostic errors and their potential effects on treatment as well as concerns regarding the Keywords Coma Vegetative state Minimally negative associations intrinsic to the term vegetative state, conscious state Locked-in syndrome Consciousness the European Task Force on Disorders of Consciousness Unresponsive wakefulness syndrome has recently proposed the more neutral and descriptive term unresponsive wakefulness syndrome. When vegeta- tive/unresponsive patients show minimal signs of con- Introduction sciousness but are unable to reliably communicate the term minimally responsive or minimally conscious state (MCS) We will here discuss the