naa a22 4500 510740308 CHVBK 20180411083025.0 cr unu---uuuuu 180411e20130301xx s 000 0 eng 10.1007/s11845-012-0825-6 doi (NATIONALLICENCE)springer-10.1007/s11845-012-0825-6 The vegetative and minimally conscious states: a review of the literature and preliminary survey of prevalence in Ireland [Elektronische Daten] [M. Ní Lochlainn, S. Gubbins, S. Connolly, R. Reilly] Background: In the absence of reliable, objective and direct measures of awareness, the diagnosis and prognosis of the vegetative and minimally conscious states are greatly complicated. This has led to an unacceptably high level of misdiagnosis. Although diagnosis and prognosis have typically relied on bedside behavioural measures, a number of recent studies on neuroimaging and neurophysiological methods offer the possibility of improvement in these areas. Objectives: We examined current clinical practice and possible future directions in the diagnosis, prognosis and treatment of disorders of consciousness, as well as the ethical and legal dilemmas associated with these disorders. We also summarise epidemiological data from three specialist rehabilitation hospitals in Ireland. Conclusions: We recommend an international agreement on standard behavioural assessment. This would enable greater consistency in diagnosis and prognostication, as well as improved accuracy of epidemiological data. Based on the current evidence, we advocate the introduction of neuroimaging and neurophysiological techniques into the standardised investigation profile. A more detailed epidemiological study is also required in Ireland. Royal Academy of Medicine in Ireland, 2012 Vegetative state nationallicence Minimally conscious state nationallicence End of life decisions nationallicence Traumatic brain injury nationallicence Coma outcomes nationallicence Ní Lochlainn M. School of Medicine, Trinity College Dublin, Dublin, Ireland aut Gubbins S. School of Medicine, Trinity College Dublin, Dublin, Ireland aut Connolly S. Department of Clinical Neurophysiology, St. Vincent's University Hospital, Dublin, Ireland aut Reilly R. School of Medicine, Trinity College Dublin, Dublin, Ireland aut Irish Journal of Medical Science Springer-Verlag 182/1(2013-03-01), 7-15 0021-1265 182:1<7 2013 182 11845 https://doi.org/10.1007/s11845-012-0825-6 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11845-012-0825-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ní Lochlainn M. School of Medicine, Trinity College Dublin, Dublin, Ireland aut NATIONALLICENCE 700 1- Gubbins S. School of Medicine, Trinity College Dublin, Dublin, Ireland aut NATIONALLICENCE 700 1- Connolly S. Department of Clinical Neurophysiology, St. Vincent's University Hospital, Dublin, Ireland aut NATIONALLICENCE 700 1- Reilly R. School of Medicine, Trinity College Dublin, Dublin, Ireland aut NATIONALLICENCE 773 0- Irish Journal of Medical Science Springer-Verlag 182/1(2013-03-01), 7-15 0021-1265 182:1<7 2013 182 11845 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer