Abstract
Objective
Methods
Results
List of abbreviations:
AAN (American Academy of Neurology), CI (confidence interval), DoC (disorders of consciousness), eMCS (emergence from minimally conscious state), LEP (laser-evoked potential), LR (likelihood ratio), MCS (minimally conscious state), MSTF (Multi-Society Task Force), OR (odds ratio), PVS (persistent vegetative state), UWS (unresponsive wakefulness syndrome), VS (vegetative state)Purchase one-time access:
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- The Diagnosis of Stupor and Coma, 3rd ed..FA Davis, Philadelphia1982
- Medical aspects of the persistent vegetative state (first of two parts).N Engl J Med. 1994; 330: 1499-1508
- The minimally conscious state: definition and diagnostic criteria.Neurology. 2002; 58: 349-353
- Medical complications and mortality of patients in the postcomatose unawareness (PC-U) state.Acta Neurochir. 1991; 112: 110-112
- Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome.BMC Med. 2010; 8: 68
- Consensus conference: rehabilitation of persons with traumatic brain injury: consensus development panel on rehabilitation of persons with traumatic brain injury.JAMA. 1999; 282: 974-983
- Practice parameter: assessment and management of patients in the persistent vegetative state (summary statement).Neurology. 1995; 45: 1015-1018
- The vegetative state.J Neurol Neurosurg Psychiatry. 2002; 73: 355-357
- Clinical characteristics of patients in the persistent vegetative state.Arch Intern Med. 1991; 151: 930-932
- The persistent vegetative state: the medical reality (getting the facts straight).Hastings Center Rep. 1988; 18: 27-32
- The persistent vegetative state: 1990.J Neurol Sci. 1991; 102: 128-136
- Life expectancy of children in vegetative and minimally conscious states.Pediatr Neurol. 2000; 23: 312-319
- Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment.BMC Neurol. 2009; 9: 35
- Accuracy of diagnosis of persistent vegetative state.Neurology. 1993; 43: 1465-1467
- Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit.BMJ. 1996; 313: 13-16
- Serial yes/no reliability after traumatic brain injury: implications regarding the operational criteria for emergence from the minimally conscious state.J Neurol Neurosurg Psychiatry. 2008; 79: 216-218
- Assessment scales for disorders of consciousness: evidence-based recommendations for clinical practice and research.Arch Phys Med Rehabil. 2010; 91: 1795-1813
- A network approach to assessing cognition in disorders of consciousness.Neurology. 2010; 75: 1871-1878
- Towards the routine use of brain imaging to aid the clinical diagnosis of disorders of consciousness.Brain. 2009; 132: 2541-2552
- fMRI reveals large-scale network activation in minimally conscious patients.Neurology. 2005; 64: 514-523
- Auditory processing in the vegetative state.Brain. 2000; 123: 1589-1601
- Brief report: late improvement in consciousness after posttraumatic vegetative state.N Engl J Med. 1996; 334: 24-25
- Revisiting the vegetative state: major developments over the last decade.in: McDeavitt J. State of the Art Reviews in Physical Medicine and Rehabilitation: Traumatic Brain Injury. Hanley and Belfus, Philadelphia2001: 399-415
Giacino JT, Katz DI, Schiff ND, et al; for the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Practice guideline update recommendations summary: disorders of consciousness: report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology; the American Congress of Rehabilitation Medicine; and the National Institute on Disability, Independent Living, and Rehabilitation Research. Neurology Epub 2018 Aug 8.
- Clinical Practice Guideline Process Manual. 2011 ed..American Academy of Neurology, St. Paul2011 (Available at:) (Accessed September 2, 2016)
- GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.BMJ. 2008; 336: 924-926
- Volitional electromyographic responses in disorders of consciousness.Brain Inj. 2014; 28: 1171-1179
- Detection of response to command using voluntary control of breathing in disorders of consciousness.Front Hum Neurosci. 2014; 8: 1020
- Preservation of electroencephalographic organization in patients with impaired consciousness and imaging-based evidence of command-following.Ann Neurol. 2014; 76: 869-879
- Stratification of unresponsive patients by an independently validated index of brain complexity.Ann Neurol. 2016; 80: 718-729
- Standard EEG in diagnostic process of prolonged disorders of consciousness.Clin Neurophysiol. 2016; 127: 2379-2385
- Cortical responsiveness to nociceptive stimuli in patients with chronic disorders of consciousness: do C-fiber laser evoked potentials have a role?.PLoS One. 2015; 10 (eCollection 2015)e0144713
- Thalamofrontal connectivity mediates top-down cognitive functions in disorders of consciousness.Neurology. 2015; 84: 167-173
- Electromyographic decoding of response to command in disorders of consciousness.Neurology. 2016; 87: 2099-2107
- Dissociable endogenous and exogenous attention in disorders of consciousness.Neuroimage Clin. 2013; 3: 450-461
- True or false? Activations of language-related areas in patients with disorders of consciousness.Curr Pharm Des. 2014; 20: 4239-4247
Rosazza C, Andronache A, Sattin D, et al. Multimodal study of default-mode network integrity in disorders of consciousness. Ann Neurol Epub 2016 Mar 11.
- Automated EEG entropy measurements in coma, vegetative state/unresponsive wakefulness syndrome and minimally conscious state.Funct Neurol. 2011; 26: 25-30
- Preserved oscillatory response but lack of mismatch negativity in patients with disorders of consciousness.Clin Neurophysiol. 2011; 122: 1744-1754
- Diagnostic precision of PET imaging and functional MRI in disorders of consciousness: a clinical validation study.Lancet. 2014; 384: 514-522
Article info
Publication history
Footnotes
Correspondence American Academy of Neurology [email protected]
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
This research was supported through a memorandum of understanding among the American Academy of Neurology, the American Congress of Rehabilitation Medicine, and the National Institute on Disability and Rehabilitation Research (NIDRR). In 2014, NIDRR was moved from the US Department of Education to the Administration for Community Living of the US Department of Health and Human Services, and was renamed the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). This article does not reflect the official policy or opinions of NIDILRR or HHS and does not constitute an endorsement by NIDILRR, HHS, or other components of the federal government.
Approved by the AAN Guideline Development, Dissemination, and Implementation Subcommittee on October 21,2017; by the AAN Practice Committee on April 9, 2018; by the American Congress of Rehabilitation Medicine Board of Governors on April 30, 2018; by the National Institute on Disability, Independent Living, and Rehabilitation Research Review Committee on April 5, 2018; and by the AAN Institute Board of Directors on May 2, 2018.
This practice guideline was endorsed by the American Academy of Physical Medicine and Rehabilitation on April 4 2018; by the American College of Surgeons Committee on Trauma on July 3, 2018; and by the Child Neurology Society on April 17, 2018.
This guideline was developed by the AAN, ACRM, and NIDILRR and was published online in Neurology® and Archives of Physical Medicine and Rehabilitation® on August 8, 2018.
This guideline is in the public domain: it may be copied, published, or shared without permission from the AAN, ACRM, or NIDILRR. Please use the following attribution when republishing it: This guideline was developed by the AAN, ACRM, and NIDILRR and was published online in Neurology and Archives of Physical Medicine and Rehabilitation on August 8, 2018.