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|Year : 2016 | Volume
| Issue : 1 | Page : 198-199
Disorders of consciousness: A new taxonomy arising from different therapeutic approaches
Department of Intensive Care, San Raffaele Cassino, Cassino, Italy
|Date of Web Publication||11-Jan-2016|
Department of Intensive Care, San Raffaele Cassino, Cassino
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sara M. Disorders of consciousness: A new taxonomy arising from different therapeutic approaches. Neurol India 2016;64:198-9
I would like to contribute a brief comment related to the paper, “Intrathecal baclofen pump implantation in a patient 2 years following a traumatic brain injury resulted in regained oratory capabilities” by Lior Ungar, et al.
Several novel therapeutic approaches that have been tried for disorders of consciousness (DOC) include the intrathecal baclofen (ITB) pump implantation, zolpidem administration, corticomotor facilitation, and direct current stimulation. The main concern while trying out these techniques may be the lack of a proper theoretical background that would justify carrying out the procedure. The wide spectrum of the approaches available reflect, in my opinion, the actual absence of an unequivocally sound definition both of the state of consciousness itself and its etiology. The definition “awake but not aware” is quite appropriate in a clinical and phenomenological setting, but includes a wide spectrum of disorders and is too generalized to define a homogeneous cohort of subjects.
At San Raffaele Cassino in Italy, my group recently proposed a novel way to define this challenging group of patients., Since a very broad mix of brain pathologies may result in this unique clinical picture (being awake but not aware status), it has led to the inevitable conclusion that a single and unique etiopathological explanation for DOC may not exist. A compliance to a certain treatment rather than another may, however, suggest the subgroups of patients with DOC who may respond to a particular treatment. Obviously, sharing of data at the worldwide level would be warranted to make this technique worthwhile.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| » References|| |
Ungar L, Sharma M, Zibly Z. Intrathecal baclofen pump implantation in a patient 2 years following a traumatic brain injury resulted in regained oratory capabilities. Neurol India 2015;63:618-9.
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Pistoia F, Sacco S, Carolei A, Sarà M. Corticomotor facilitation in vegetative state: Results of a pilot study. Arch Phys Med Rehabil 2013;94:1599-606.
Formisano R, Pistoia F, Sarà M. Disorders of consciousness: A taxonomy to be changed? Brain Inj 2011;6:638-9.
Pistoia F, Sarà M. Is There a Cartesian renaissance of the mind or is it time for a new taxonomy for low responsive states? J Neurotrauma 2012;29:2328-31.