Answered Questions is a monthly resource for the Spanish language Disability Community that fills an information need. Each month, we look through the searches on our blog and through the information requests made by our patrons who speak Spanish and pick a topic that fills the largest need. Each resource mentioned below is associated with this month’s information need. We search the various Spanish language news sources and feeds throughout the month to bring you these articles. With the exception of articles from the NIDILRR Grantees and Further Research, all the linked articles and resources are in Spanish – any that are in English will be clearly marked. This month’s question is: What are disorders of consciousness (DOC)? This edition of Answered Questions includes items that answer what a coma is; describe research in DOC; describe the difference between types of DOC; describe a persistent DOC; and describe the perceptions of family members of people with DOC.
Articles from NIDILRR Grantees:
Diagnosis and decision making for patients with disorders of consciousness: A survey among family members (J70681)
This article in the Archives of Physical Medicine and Rehabilitation describes a study that examined the perceptions of family members of people with DOC in relation to their level of consciousness, communicative status, and prognosis when compared to the objective medical categories, and determined the family member’s self-reported decision-making practice when it came to treatment. The findings, as described in the article, suggest that family members of people with DOC generally asses correctly the level of consciousness and express a great wish to begin communicating again with the person with DOC.
Special Issue: Advances in disorders of consciousness (R09292)
This journal issue showcases studies that focus on patients with DOC. Topics covered in this issue include: current knowledge on severe acquired brain injury with DOC; current state of facts; what it means to be minimally conscious; potential interest of high density electroencephalography (EEG) in monitoring epilepsy; estimating the clinical utility of assessments of covert awareness in the DOC; a European survey on attitudes towards pain and end of life issues in locked in syndrome; and pain issues in DOC. A case study and a review of the literature on bilateral remote cerebellar hemorrhage after spinal surgery, along with a book review and a case report and review of cerebrospinal fluid shunt infection, were also included in this issue.
A Spanish validation of the coma recovery scale-revised (CRS-R) (J70348)
This article describes a study that examined the inter-rater reliability and concurrent validity of a Spanish translation of the Coma Recovery Scale-Revised (CRS-R). The study used a sample of 35 patients with severe acquired brain injury and tested the concurrent validity of the Spanish version of the scale by also administering the Glasgow Coma Scale (GSC) and the Disability Rating Scale (DRS). The results show that the Spanish language version of the CRS-R can be administered reliably and appears capable of differentiating patients in emergence from different types of DOC.
What is coma? (Instituto Nacional de Trastornos Neurológicos y Accidentes Cerebrovasculares)
This article from the National Institute of Neurological Disorders and Stroke (NINDS), at the National Institutes of Health (NIH), describes what a coma is, treatments, prognosis, and if there is research going on. The article also provides information on clinical trials within NIH, the US, and the rest of the world.
The persistent vegetative state. Clinical features. (Medicina Intensiva)
This article describes the clinical diagnosis of the persistent vegetative state, which requires differentiation from other alterations in the level of consciousness – including coma, brain death, and locked-in syndrome. According to the article, patients in a persistent vegetative state retain spontaneous vital signs and constants, and the sleep-wake cycle; however, they are not capable of voluntary activity. The article also defines what marks a vegetative state as persistent.
Subtle brain signals of consciousness have been detected in patients who are supposedly in a vegetative state (Noticias de la Ciencia y la Tecnología)
A team of scientists from the Canada, Chile, the United Kingdom, and the United States have found subtle brain patterns of consciousness in patients who had been diagnosed as being in a vegetative state. These patterns point to brain networks that could sustain consciousness even when a patient appears to be unconscious and unresponsive. The study could help doctors identify patients who are conscious and cannot communicate despite appearing as if they are unconscious or in a vegetative state.
Man wakes up after being in a vegetative state for 12 years: “I noticed everything” (Faro de Vigo)
Martin Pistorius, a young man from South Africa, was diagnosed at 12 years old with cryptococcal meningitis, sleeping all day and not eating anything. His doctors were not optimistic as they told his parents about his vegetative state. With the help of the hard work of his parents in caring for him, Martin is now awake, has graduated college, is employed, and will soon be married. You can read more about Martin’s story in his book: “Ghost Boy”
- USA – The Model System Knowledge Translation Center financed by NIDILRR (H133A110004) has a very informative fact sheet on vegetative and minimally conscious states after sever brain injuries. The factsheet includes information on characteristics of coma, minimally conscious state, and vegetative state; the care that persons in a coma or vegetative state may require; treatments used; patterns of recovery; and more.