ABSTRACT
After severe brain injury, people usually experience a period of coma. If they survive, they may go through different states of consciousness, such as the unresponsive wakefulness syndrome and the minimally conscious state. Diagnosis currently depends on behavioural assessment, which is prone to misdiagnosis (Stender et al., 2014a). Neuroimaging techniques, including magnetic resonance imaging and positron emission tomography, and neurophysiological tools, such as electroencephalography and transcranial magnetic stimulation, have been shown to improve diagnosis accuracy, especially in cases of aphasia or paralysis. Regardless of diagnosis, clinical management of patients with disorders of consciousness is challenging. Pain management, physiotherapy and speech therapy are essential to optimise the patient's condition. Curative treatments presently available include drug-based interventions (e.g. amantadine and zolpidem) and brain stimulation techniques. Well-being of the patients, their families and professional caregivers is important to address, as the psychological burden of dealing with these patients is high. A dialogue between the concerned parties is crucial to promote more efficient medical care of these challenging patients.
