By Steven Laureys, Olivia Gosseries, Giulio Tononi
Knowing attention is the key unsolved challenge in biology. One more and more very important approach to learning awareness is to review problems of cognizance, e.g. mind harm and sickness states resulting in vegetative states, coma, minimally unsleeping states, and so on. lots of those experiences are greatly within the public eye due to their courting to controversies approximately coma sufferers (e.g. Terry Schiavo case within the US recently), and the connection to 1 of the main philosophical, sociological, political, and spiritual questions of humankind.
This is the 1st ebook to summarize our present figuring out of the neuroanatomical and sensible underpinnings of human awareness through emphasizing a lesional strategy provided through the examine of neurological sufferers. the chosen individuals are all impressive authors and undisputed leaders of their field.
- the 1st significant publication at the Neurology of recognition, i.e. at the examine of mind damages and sickness states that result in various degrees of disturbances in human realization (vegetative, coma, minimally awake states, etc)
- dependent, illustrated, and priced to be beautiful to a large industry, together with scholars in Neuroscience, Neurology, Psychology, Psychiatry etc
- Articles from the most researchers within the box, together with Christof Koch, Marcus Raichle, Allan Hobson, Nicholas Schiff, Joseph Fins, Michael Gazzaniga, Lionel Naccache
- certain and entire in its focus
- of serious curiosity within the moral dialogue of coma situations, features a bankruptcy at the ethics through JJ Fins
- of significant curiosity to anyone considering recognition as one of many significant philosophical, sociological, political, and non secular questions of our time
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Extra resources for The Neurology of Consciousness: Cognitive Neuroscience and Neuropathology
In akinetic mutism [6, 51, 52] the patient appears fully awake, and unlike the vegetative state, they will visually track the examiner. However, they usually do not respond to any commands. Akinetic mutism can be viewed as an extreme form of abulia, often resulting from frontal lesions, in which patients usually sit passively, but may occasionally respond to questions or commands after a long delay. In some patients, abulia or akinetic mutism can be reversed with dopaminergic agonists. Some consider akinetic mutism to be a subcategory of the minimally conscious state , however, the Aspen Workgroup considered akinetic mutism to be primarily a defect in motor initiation rather than in consciousness .
Prolonged and repeated evaluation is often necessary to make this distinction, and to determine with confidence whether some preserved consciousness is present [2, 4, 5]. As in the vegetative state (but unlike in coma), patients in the minimally conscious state do have sleep–wake cycles . Patients are considered to no longer be in the minimally conscious state if they display functional interactive communication, or functional use of two different objects . ’). , bringing a comb to the head, or a pencil to a sheet of paper) .
3 Neurological Examination in States of Impaired Consciousness Brain death Coma Vegetative state Minimally conscious or better No No No No No No No No Yes No No Yes Yes Yes, variable Yes Yes No No No No No No Yes Yes No Yes Yes Yes Yes, at times Yes Yes Yes Cranial nerves Pupil light reflex Eye closure to bright light No No Yes No Yes Yes Blink to threat No No Optokinetic nystagmus Visual tracking Orienting movement of eyes and head towards visual, auditory, or tactiled stimuli Spontaneous roving or other eye movements Eyes move in response to oculocephalic maneuver or cold water calorics No No No No No No Yes Caution advisedb Caution advisedb Noc No Yes No No Yes Yes Yes Yes Corneal reflex No Yes Yes Yes Yes (but may be masked by voluntary eye movements) Yes Testa Mental status Sleep–wake cycles Responds appropriately to questions/commands Says single words (may be inappropriate) Orienting movements (eyes, head, body) towards visual, tactile, or auditory stimuli Noxious stimuli (loud voice, nasal tickle, endotracheal suctioning, pressure to orbital ridge, mandible, sternum, or nail bed) Speaks, purposeful movements Opens eyes, basic orienting movements Grunts, moans Grimaces Noxious stimuli → limb movements (see sensory/motor examination below) I.
The Neurology of Consciousness: Cognitive Neuroscience and Neuropathology by Steven Laureys, Olivia Gosseries, Giulio Tononi