How Can We Tell If a Comatose Patient Is Conscious?

One of the more horrifying disorders one can experience is locked-in syndrome, in which a person is conscious, but cannot move or cannot communicate. Because of the lack of communication, caregivers often don't know the patient is conscious. Doctors are now more awareness of the possibility that completely paralyzed patients may retain consciousness, so they consult with neurologist Steven Laureys of the University of Lige in Belgium, who has developed testing methods for reaching conscious but uncommunicative patients.

Patients are brought to Lige from all over Europe to undergo testing. How do you determine whether they are conscious?

Well, of course, the physician will say, “Squeeze my hand”—but this time while the patient is in a brain scanner. If the motor cortex is activated, we know that the patient heard and understood and therefore is conscious. We also want to determine the chances of recovery and what the physician or the patient’s family can do. With different brain scanners, I can find out where brain damage is located and which connections are still intact. This information tells family members what the chances of recovery are. If the results show that there is no hope whatsoever, we then discuss difficult topics with the family, such as end-of-life options. Occasionally we see much more brain activity than anticipated, and then we can initiate treatment aimed at rehabilitation.

Once the possibility of consciousness is determined, medical science has ways of stimulating the brain if necessary, and facilitating communication by whatever means the patient has available, for example, a computer that scans eye movement. Read the rest of the interview with Dr. Laureys at Scientific American. -via Boing Boing

(Image credit: HannahDoverty)


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