Mirror efficiency in the assessment of visual pursuit in patients in minimally conscious state

Wannez, Sarah; Vanhaudenhuyse, Audrey; Laureys, Steven; Brédart, Serge

doi:10.1080/02699052.2017.1376755

Cited by 23 publications

(16 citation statements)

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“…PICO questions 1–3 refer to clinical signs, PICO questions 4–8 to clinical rating scales. Thirteen publications were included for final analysis . PICO 1 Should the patient's eyelids be opened by the examiner to diagnose voluntary eye movements in patients with DoC without spontaneous eye opening? …”

Section: Resultsmentioning

confidence: 99%

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European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness

Kondziella

Bender

Diserens

et al. 2020

Euro J of Neurology

488

392

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Section: Resultsmentioning

confidence: 99%

“…Three studies were eligible for inclusion . One study was excluded due to complete patient overlap , resulting in two studies with a total of 272 patients.…”

Section: Resultsmentioning

confidence: 99%

European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness

Kondziella

Bender

Diserens

et al. 2020

Euro J of Neurology

488

392

View full text Add to dashboard Cite

show abstract

“…Cheng and Gosseries et al found that the name of the patient is more suitable for the detection of auditory localization than other sound stimuli [36]. Vanhaudenhuys et al also found that the best way to check visual pursuit in MCS patients is to use a moving mirror rather than a moving object or person [37,38]. Therefore, the application of personally related visual and auditory stimulation can better reduce the misdiagnosis rate of patients compared with natural stimulation [31].…”

Section: Resultsmentioning

confidence: 99%

Misdiagnosis rate of the prolonged disorders of consciousness on a clinical consensus compared with a repeated Coma-Recovery Scale-Revised assessment

Wang

Zhang

et al. 2019

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Background: Previous studies have shown that a single Coma-Recovery Scale-Revision (CRS-R) assessment can identify high misdiagnosis rate for a clinical consensus. The aim of this study was to investigate the misdiagnosis rate of clinical consensus compared to repeated behavior scale assessments in patients with prolonged disorders of consciousness (DOC). Methods: Patients with prolonged DOC during hospitalization were screened by clinicians, and the clinicians formed a clinical consensus diagnosis. Trained professionals also used the CRS-R to evaluate the consciousness levels of the enrolled patients for repeated times (≥5 times) within a week. After the repeated evaluation results, the enrolled patients with prolonged DOC were divided into unresponsive wakefulness syndrome (UWS), minimally conscious state (MCS), and emergence from MCS (EMCS). Furthermore, the relationship between the results of the CRS-R and the clinical consensus were analyzed. Results: In this study, 137 patients with a clinical consensus of prolonged DOC were enrolled. After the single CRS-R behavior evaluation, it was found that the misdiagnosis rate of clinical MCS was 24.7%, while the repeated CRS-R evaluation results showed that the misdiagnosis rate of clinical MCS was 38.2%. A total of 16.7% of EMCS cases were misdiagnosed as MCS, and 1.1% of EMCS cases were misdiagnosed as UWS. Conclusions: The current clinical consensus of the misdiagnosis rate is still relatively high. Therefore, clinicians should be aware of the importance of the bedside CRS-R behavior assessment and should apply the CRS-R tool to daily procedures.

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“…Some behaviors, such as visual fixation and pursuit, are particularly susceptible to this problem. There is evidence that both visual fixation and pursuit are more likely to occur in response to presentation of a mirror as compared to an object or person [30,39,40]. This concern is mitigated by the fact that the CRS-R has strong inter-rater reliability [9,41,42] and all clinical staff were required to undergo training before using the scale.…”

Section: Discussionmentioning

confidence: 99%

Which behaviours are first to emerge during recovery of consciousness after severe brain injury?

Martens

Bodien

Sheau

et al. 2020

Annals of Physical and Rehabilitation Medicine

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Mirror efficiency in the assessment of visual pursuit in patients in minimally conscious state

Abstract: Although our results suggest that the hypothesis proposed by previous studies was partly wrong, they confirm that the mirror is the best stimulus to use when assessing visual pursuit.

Cited by 23 publications

References 23 publications

European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness

European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness

Misdiagnosis rate of the prolonged disorders of consciousness on a clinical consensus compared with a repeated Coma-Recovery Scale-Revised assessment

Which behaviours are first to emerge during recovery of consciousness after severe brain injury?

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