Review of the American Congress of Rehabilitation Medicine (ACRM) clinical recommendations for the diagnosis and treatment of patients with chronic impairment of consciousness

Belkin, V.А.

doi:10.18565/pharmateca.2019.3.14-19

Pharmateca

2019

DOI: 10.18565/pharmateca.2019.3.14-19

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Review of the American Congress of Rehabilitation Medicine (ACRM) clinical recommendations for the diagnosis and treatment of patients with chronic impairment of consciousness

V.А. Belkin¹

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Routing of Patients with Acquired Brain Injury as a Tool for Collecting Epidemiological Data about Disorders of Consciousness

Belkin

Ryabinkina

Ivanova

et al. 2020

Bulletin of Restorative Medicine

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Introduction. Disorders of consciousness (DOC) form one of the most underexplored sections of neurosciences. An epidemiology of DOC may be crucial to evaluate the extent of this problem. There were several attempts to collect such data in different countries allover the world, but all of them seem to be very discrete.objective. Aim of the study was to compile information about patients of Sverdlovsk Region in which acquired brain injury (ABI) resulted in DOC, find out their outcomes and evaluate the prevalence rate of these states in the population of the region.Methods.6507 patients with ABI were monitored by Regional Neurocritical Care Center in Sverdlovsk Regional Hospital №1 during 2019. 492 patients from this group then were assessed by neurorehabilitation physicians of Clinical Institute of Brain (CIB) via telemedicineconsultation; 122 of them were directed to CIB for in-patient stage of treatment, the main intention of which was an advanced diagnostic of the level of consciousness. Unresponsive wakefulness syndrome (UWS) was confirmed in 29 patients.results. After in-patient stage of treatment changes in the level of consciousness were assessed by follow-up via telemedicine consultation.to the end of January 2020, it made possible to find out that 9 of 29 UWS patients regained the level of consciousness; thus,20 patients remained unresponsive. taking into account that population of Sverdlovsk region numbers 4,3 million, prevalence rate ofnew UWS cases in region equaled 0,46/100 000.Conclusion. Application of telemedicine consultation allows to enquire DOC patients’ outcomes regardless of the patient location.Implementation of telemedicine can be useful for collecting this data and further analysis of revealed trends.

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Routing of Patients with Acquired Brain Injury as a Tool for Collecting Epidemiological Data about Disorders of Consciousness

Belkin

Ryabinkina

Ivanova

et al. 2020

Bulletin of Restorative Medicine

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Cognitive motor dissociation in patients with chronic disorders of consciousness: a literature review

Belkin

Андреевич²,

Ilina

et al. 2021

Annals of Clinical and Experimental Neurology

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Chronic disorders of consciousness include several conditions that differ significantly in both clinical and neurophysiological features. As medical technology continues to develop, the differential diagnosis of disorders of consciousness extends beyond purely clinical work. Nevertheless, all types of consciousness disorders are united by varying degrees of dissociation between wakefulness, cognitive and motor activity. The external similarity and minimal differences in clinical symptoms in unresponsive patients may hide different morphofunctional variants of this condition. In particular, use of electroencephalography and functional magnetic re- sonance imaging techniques allows us to detect covert consciousness in some clinically unresponsive patients. Based on various estimates, this phenomenon occurs in 515% of all cases. A special instance of covert consciousness is cognitive motor dissociation (CMD), defined as activation of cortical motor centers, recorded using neurophysiological techniques, in response to a corresponding instruction to perform a movement without its visible performance. Some researchers believe that detection of CMD indicates a more favourable prognosis for the subsequent restoration of consciousness, rather than its absence. The aim of this review is to examine CMD and its potential significance for outcomes in patients with chronic disorders of consciousness.

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Review of the American Congress of Rehabilitation Medicine (ACRM) clinical recommendations for the diagnosis and treatment of patients with chronic impairment of consciousness

Cited by 2 publications

References 0 publications

Routing of Patients with Acquired Brain Injury as a Tool for Collecting Epidemiological Data about Disorders of Consciousness

Routing of Patients with Acquired Brain Injury as a Tool for Collecting Epidemiological Data about Disorders of Consciousness

Cognitive motor dissociation in patients with chronic disorders of consciousness: a literature review

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