Examining Unresponsive Patients
Basics Come First
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Our understanding of the spectrum of consciousness has been expanded in recent years by research showing that some patients with brain injury who seem completely unaware at the bedside may be capable of activating specific brain regions in appropriate response to external commands; such responses can be reliably documented using functional MRI or special electroencephalography techniques.1,2 The terms cognitive motor dissociation (CMD) and covert awareness have been proposed to classify this condition characterized by command following identified by advanced radiologic or electrophysiologic methods without discernible motor responses on physical examination.3 However, practical application of this knowledge has been hampered by the limited availability of these advanced diagnostic tools and of the expertise needed for their optimal interpretation.
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Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the editorial.
See page 1144
- Received January 4, 2023.
- Accepted in final form January 26, 2023.
- © 2023 American Academy of Neurology
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