| Pain assessment and management in disorders of consciousness. | |
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MedLine Citation:
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PMID: 17992079 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: Pain and suffering controversies in persons with disorders of consciousness continue to be debated by the scientific, legal and medical ethics communities. This review examines the current knowledge base for guiding decisions regarding assessment and management of pain in persons with disorders of consciousness. RECENT FINDINGS: Studies have shown that brain processing linked to pain in persons in a vegetative state is incomplete and is processed only at a primary and not higher secondary level. Therefore, such painful stimuli would not reach the threshold for conscious experience. In contrast, persons in a minimally conscious state have been shown to have brain activation patterns to pain similar to controls. Therefore, these patients may have sufficient cortical integration and access to afferent information to allow for nociceptive stimuli to be consciously processed. Data to date do not allow for differentiation of the degree of any conscious pain experience or determination of whether individuals with disorders of consciousness are able to suffer. SUMMARY: Pain and suffering should be considered in all persons with disorders of consciousness and adequately treated. Behavioural assessment scales developed for patients unable to speak could be used to assess pain. Future studies should focus on methodologies for specific pain measures relevant to this unique and challenging patient population. |
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Authors:
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Caroline Schnakers; Nathan D Zasler |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Current opinion in neurology Volume: 20 ISSN: 1350-7540 ISO Abbreviation: Curr. Opin. Neurol. Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-11-09 Completed Date: 2008-01-11 Revised Date: 2013-01-18 |
Medline Journal Info:
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Nlm Unique ID: 9319162 Medline TA: Curr Opin Neurol Country: England |
Other Details:
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Languages: eng Pagination: 620-6 Citation Subset: IM |
Affiliation:
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Coma Science Group, University of Liege, Liege, Belgium. c.schnakers@student.ulg.ac.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Analgesics
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therapeutic use Brain / anatomy & histology, physiopathology* Consciousness / physiology Consciousness Disorders / complications*, physiopathology* Humans Nerve Net / anatomy & histology, physiopathology Pain / diagnosis*, physiopathology* Pain Management Pain Measurement / methods*, standards Persistent Vegetative State / complications, physiopathology |
| Chemical | |
Reg. No./Substance:
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0/Analgesics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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