disorders of consciousness; locked-in syndrome; nociception; pain; pain assessment; pain management; theories of pain
Abstract :
[en] The assessment and management of pain and nociception is very challenging in patients unable to communicate functionally such as patients with disorders of consciousness (DoC) or in locked-in syndrome (LIS). In a clinical setting, the detection of signs of pain and nociception by the medical staff is therefore essential for the wellbeing and management of these patients. However, there is still a lot unknown and a lack of clear guidelines regarding the assessment, management and treatment of pain and nociception in these populations. The purpose of this narrative review is to examine the current knowledge regarding this issue by covering different topics such as: the neurophysiology of pain and nociception (in healthy subjects and patients), the source and impact of nociception and pain in DoC and LIS and, finally, the assessment and treatment of pain and nociception in these populations. In this review we will also give possible research directions that could help to improve the management of this specific population of severely brain damaged patients.
Disciplines :
Neurology
Author, co-author :
Bonin, Estelle ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group ; Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
Lejeune, Nicolas ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group ; Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium ; Centre Hospitalier Neurologique (CHN) William Lennox, Saint-Luc Hospital Group, Ottignies-Louvain-la-Neuve, Belgium ; Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
Szymkowicz, Emilie ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group ; Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
Bonhomme, Vincent ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation ; Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
Martial, Charlotte ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group ; Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
Gosseries, Olivia ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group ; Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
Laureys, Steven ; Centre Hospitalier Universitaire de Liège - CHU > > Centre du Cerveau² ; Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium ; Joint International Research Unit on Consciousness, CERVO Brain Research Centre, Centre Intégré Universitaire de Santé et Services Sociaux (CIUSS), University Laval, Québec City, QC, Canada
Thibaut, Aurore ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group ; Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
Language :
English
Title :
Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review.
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