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      The minimally conscious state: Definition and diagnostic criteria

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          Abstract

          To establish consensus recommendations among health care specialties for defining and establishing diagnostic criteria for the minimally conscious state (MCS). There is a subgroup of patients with severe alteration in consciousness who do not meet diagnostic criteria for coma or the vegetative state (VS). These patients demonstrate inconsistent but discernible evidence of consciousness. It is important to distinguish patients in MCS from those in coma and VS because preliminary findings suggest that there are meaningful differences in outcome. An evidence-based literature review of disorders of consciousness was completed to define MCS, develop diagnostic criteria for entry into MCS, and identify markers for emergence to higher levels of cognitive function. There were insufficient data to establish evidence-based guidelines for diagnosis, prognosis, and management of MCS. Therefore, a consensus-based case definition with behaviorally referenced diagnostic criteria was formulated to facilitate future empirical investigation. MCS is characterized by inconsistent but clearly discernible behavioral evidence of consciousness and can be distinguished from coma and VS by documenting the presence of specific behavioral features not found in either of these conditions. Patients may evolve to MCS from coma or VS after acute brain injury. MCS may also result from degenerative or congenital nervous system disorders. This condition is often transient but may also exist as a permanent outcome. Defining MCS should promote further research on its epidemiology, neuropathology, natural history, and management.

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          Author and article information

          Journal
          Neurology
          Neurology
          Ovid Technologies (Wolters Kluwer Health)
          0028-3878
          1526-632X
          February 12 2002
          February 12 2002
          : 58
          : 3
          : 349-353
          Article
          10.1212/WNL.58.3.349
          11839831
          8ef70ecc-c82b-4b44-98c6-d2901d00a0e9
          © 2002
          History

          Molecular medicine,Neurosciences
          Molecular medicine, Neurosciences

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