Article (Scientific journals)
European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness
Kondziella, Daniel; Bender, Andreas; Diserens, Karin et al.
2020In European Journal of Neurology, 27 (5), p. 741-756
Peer Reviewed verified by ORBi
 

Files


Full Text
Kondziell_European_2020.pdf
Publisher postprint (1.82 MB)
Download

All documents in ORBi are protected by a user license.

Send to



Details



Abstract :
[en] Background and purpose: Patients with acquired brain injury and acute or prolonged disorders of consciousness (DoC) are challenging. Evidence to support diagnostic decisions on coma and other DoC is limited but accumulating. This guideline provides the state-of-the-art evidence regarding the diagnosis of DoC, summarizing data from bedside examination techniques, functional neuroimaging and electroencephalography (EEG). Methods: Sixteen members of the European Academy of Neurology (EAN) Scientific Panel on Coma and Chronic Disorders of Consciousness, representing 10 European countries, reviewed the scientific evidence for the evaluation of coma and other DoC using standard bibliographic measures. Recommendations followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The guideline was endorsed by the EAN. Results: Besides a comprehensive neurological examination, the following suggestions are made: probe for voluntary eye movements using a mirror; repeat clinical assessments in the subacute and chronic setting, using the Coma Recovery Scale – Revised; use the Full Outline of Unresponsiveness score instead of the Glasgow Coma Scale in the acute setting; obtain clinical standard EEG; search for sleep patterns on EEG, particularly rapid eye movement sleep and slow-wave sleep; and, whenever feasible, consider positron emission tomography, resting state functional magnetic resonance imaging (fMRI), active fMRI or EEG paradigms and quantitative analysis of high-density EEG to complement behavioral assessment in patients without command following at the bedside. Conclusions: Standardized clinical evaluation, EEG-based techniques and functional neuroimaging should be integrated for multimodal evaluation of patients with DoC. The state of consciousness should be classified according to the highest level revealed by any of these three approaches. © 2020 European Academy of Neurology
Research center :
CHU de Liège-Centre du Cerveau² - ULiège
Disciplines :
Neurosciences & behavior
Author, co-author :
Kondziella, Daniel;  Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark, Department of Neurosciences, Norwegian University of Science and Technology, Trondheim, Norway
Bender, Andreas;  Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany, Therapiezentrum Burgau, Burgau, Germany
Diserens, Karin;  Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
van Erp, Willemijn ;  Université de Liège - ULiège > GIGA
Estraneo, Anna;  Neurology Unit, Santa Maria della Pietà General Hospital, Nola, Italy, IRCCS Fondazione don Carlo Gnocchi ONLUS, Florence, Italy
Formisano, Rita;  Post-Coma Unit, Neurorehabilitation Hospital and Research Institution, Santa Lucia Foundation, Rome, Italy
Laureys, Steven  ;  Université de Liège - ULiège > GIGA Consciousness-Coma Science Group
Naccache, Lionel;  Department of Neurology, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris, France, Sorbonne Université, UPMC Univ Paris 06, Faculté de Médecine Pitié-Salpêtrière, Paris, France
Ozturk, Şerefnur;  Department of Neurology, Faculty of Medicine, Selcuk University, Konya, Turkey
Rohaut, Benjamin;  Department of Neurology, AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris, France, Sorbonne Université, UPMC Univ Paris 06, Faculté de Médecine Pitié-Salpêtrière, Paris, France, Neuro-ICU, Department of Neurology, Columbia University, New York, NY, United States
Sitt, Jacobo Diego;  Sorbonne Université, UPMC Univ Paris 06, Faculté de Médecine Pitié-Salpêtrière, Paris, France
Stender, Johan;  Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Tiainen, Marjaana;  Department of Neurology, Helsinki University Hospital, Helsinki, Finland
Rossetti, Andrea O.;  Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
Gosseries, Olivia  ;  Université de Liège - ULiège > Consciousness-Coma Science Group
Chatelle, Camille ;  Coma Science Group, GIGA Consciousness, University and University Hospital of Liège, Liège, Belgium, Laboratory for NeuroImaging of Coma and Consciousness – Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States
More authors (6 more) Less
Language :
English
Title :
European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness
Publication date :
2020
Journal title :
European Journal of Neurology
ISSN :
1351-5101
eISSN :
1468-1331
Publisher :
Blackwell Publishing Ltd
Volume :
27
Issue :
5
Pages :
741-756
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 06 July 2020

Statistics


Number of views
1603 (12 by ULiège)
Number of downloads
1190 (13 by ULiège)

Scopus citations®
 
294
Scopus citations®
without self-citations
221
OpenCitations
 
173

Bibliography


Similar publications



Contact ORBi