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Neuropsychological Assessment and Management of People in States of Impaired Consciousness: An Overview of Some Recent Studies

Published online by Cambridge University Press:  21 February 2012

Barbara A. Wilson ,
Martin R. Coleman  and
John D. Pickard
Barbara A. Wilson*
Affiliation:
Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom; The Oliver Zangwill Centre for Neuropsychological Rehabilitation, Ely, United Kingdom. barbara.wilson@mrc-cbu.cam.ac.uk
Martin R. Coleman
Affiliation:
Impaired Consciousness Study Group, University of Cambridge, United Kingdom.
John D. Pickard
Affiliation:
Impaired Consciousness Study Group, University of Cambridge, United Kingdom.
*
*Address for correspondence: Barbara A Wilson, MRC Cognition and Brain Sciences Unit, Box 58, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, United Kingdom.
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Abstract

This article is concerned with patients in coma, the vegetative, or minimally conscious states. Studies addressing the issue of assessment and management of these patients are described. These include (a) the development of an assessment tool (Wessex Head Injury Matrix, WHIM); (b) use of the WHIM to assess the effects of posture on arousal, showing that some 75% of patients show more behaviours when assessed while they are in a standing frame than when supine; (c) a comparison of the WHIM with the Glasgow Coma Scale, demonstrating that the WHIM is more sensitive than the GCS for measuring the behavioural repertoire of people in states of reduced consciousness; (d) a discussion of situations when neuro-imaging techniques are required to assess residual functioning; and (e) the long term outcome of one of the first vegetative patients to be scanned with Positron Emission Tomography (PET). We conclude with a discussion about neuropsychology and patients in states of impaired consciousness.

Keywords

comavegetative stateimpaired consciousnessassessment
Type
Clinical Practice: Current Opinion
Information
Brain Impairment , Volume 9 , Issue 1 , 01 May 2008 , pp. 28 - 35
Copyright
Copyright © Cambridge University Press 2008

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