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专注于微妙的迹象和运动行为推出没有响应从患者的意识
在临床的重要性
第一次出版2023年2月28日,
DOI: https://doi.org/10.1212/WNL.0000000000207067
卡琳Diserens
从神经学和急性Ne首页urorehabilitation单元(降低价格,I.A.M.,J.J.,P.R.), Department of Clinical Neurosciences, and Department of Radiology (V.D., P.P.), Lausanne University Hospital and University of Lausanne; University Hospital of Old Age Psychiatry (I.A.M.), University of Bern, Switzerland; Neurology Unit (A.P.), Department of Medicine, Hôpitaux Robert Schuman, Luxembourg; Department of Neuroscience (D.F.M.), Luliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery (R.D.S.), School of Medicine, Johns Hopkins University, Baltimore, MD; Feil Family Brain and Mind Research Institute (N.D.S.), Weill Cornell Medical College, New York, NY; and Department of Neurology (N.D.S.), New York Presbyterian Hospital.
Ivo a·迈耶
从神经学和急性Ne首页urorehabilitation单元(降低价格,I.A.M.,J.J.,P.R.), Department of Clinical Neurosciences, and Department of Radiology (V.D., P.P.), Lausanne University Hospital and University of Lausanne; University Hospital of Old Age Psychiatry (I.A.M.), University of Bern, Switzerland; Neurology Unit (A.P.), Department of Medicine, Hôpitaux Robert Schuman, Luxembourg; Department of Neuroscience (D.F.M.), Luliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery (R.D.S.), School of Medicine, Johns Hopkins University, Baltimore, MD; Feil Family Brain and Mind Research Institute (N.D.S.), Weill Cornell Medical College, New York, NY; and Department of Neurology (N.D.S.), New York Presbyterian Hospital.
简Johr
从神经学和急性Ne首页urorehabilitation单元(降低价格,I.A.M.,J.J.,P.R.), Department of Clinical Neurosciences, and Department of Radiology (V.D., P.P.), Lausanne University Hospital and University of Lausanne; University Hospital of Old Age Psychiatry (I.A.M.), University of Bern, Switzerland; Neurology Unit (A.P.), Department of Medicine, Hôpitaux Robert Schuman, Luxembourg; Department of Neuroscience (D.F.M.), Luliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery (R.D.S.), School of Medicine, Johns Hopkins University, Baltimore, MD; Feil Family Brain and Mind Research Institute (N.D.S.), Weill Cornell Medical College, New York, NY; and Department of Neurology (N.D.S.), New York Presbyterian Hospital.
亚历山德罗Pincherle
从神经学和急性Ne首页urorehabilitation单元(降低价格,I.A.M.,J.J.,P.R.), Department of Clinical Neurosciences, and Department of Radiology (V.D., P.P.), Lausanne University Hospital and University of Lausanne; University Hospital of Old Age Psychiatry (I.A.M.), University of Bern, Switzerland; Neurology Unit (A.P.), Department of Medicine, Hôpitaux Robert Schuman, Luxembourg; Department of Neuroscience (D.F.M.), Luliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery (R.D.S.), School of Medicine, Johns Hopkins University, Baltimore, MD; Feil Family Brain and Mind Research Institute (N.D.S.), Weill Cornell Medical College, New York, NY; and Department of Neurology (N.D.S.), New York Presbyterian Hospital.
文森特Dunet
从神经学和急性Ne首页urorehabilitation单元(降低价格,I.A.M.,J.J.,P.R.), Department of Clinical Neurosciences, and Department of Radiology (V.D., P.P.), Lausanne University Hospital and University of Lausanne; University Hospital of Old Age Psychiatry (I.A.M.), University of Bern, Switzerland; Neurology Unit (A.P.), Department of Medicine, Hôpitaux Robert Schuman, Luxembourg; Department of Neuroscience (D.F.M.), Luliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery (R.D.S.), School of Medicine, Johns Hopkins University, Baltimore, MD; Feil Family Brain and Mind Research Institute (N.D.S.), Weill Cornell Medical College, New York, NY; and Department of Neurology (N.D.S.), New York Presbyterian Hospital.
Polona Pozeg
从神经学和急性Ne首页urorehabilitation单元(降低价格,I.A.M.,J.J.,P.R.), Department of Clinical Neurosciences, and Department of Radiology (V.D., P.P.), Lausanne University Hospital and University of Lausanne; University Hospital of Old Age Psychiatry (I.A.M.), University of Bern, Switzerland; Neurology Unit (A.P.), Department of Medicine, Hôpitaux Robert Schuman, Luxembourg; Department of Neuroscience (D.F.M.), Luliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery (R.D.S.), School of Medicine, Johns Hopkins University, Baltimore, MD; Feil Family Brain and Mind Research Institute (N.D.S.), Weill Cornell Medical College, New York, NY; and Department of Neurology (N.D.S.), New York Presbyterian Hospital.
菲利普Ryvlin
从神经学和急性Ne首页urorehabilitation单元(降低价格,I.A.M.,J.J.,P.R.), Department of Clinical Neurosciences, and Department of Radiology (V.D., P.P.), Lausanne University Hospital and University of Lausanne; University Hospital of Old Age Psychiatry (I.A.M.), University of Bern, Switzerland; Neurology Unit (A.P.), Department of Medicine, Hôpitaux Robert Schuman, Luxembourg; Department of Neuroscience (D.F.M.), Luliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery (R.D.S.), School of Medicine, Johns Hopkins University, Baltimore, MD; Feil Family Brain and Mind Research Institute (N.D.S.), Weill Cornell Medical College, New York, NY; and Department of Neurology (N.D.S.), New York Presbyterian Hospital.
Dafin f . Mureşanu
从神经学和急性Ne首页urorehabilitation单元(降低价格,I.A.M.,J.J.,P.R.), Department of Clinical Neurosciences, and Department of Radiology (V.D., P.P.), Lausanne University Hospital and University of Lausanne; University Hospital of Old Age Psychiatry (I.A.M.), University of Bern, Switzerland; Neurology Unit (A.P.), Department of Medicine, Hôpitaux Robert Schuman, Luxembourg; Department of Neuroscience (D.F.M.), Luliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery (R.D.S.), School of Medicine, Johns Hopkins University, Baltimore, MD; Feil Family Brain and Mind Research Institute (N.D.S.), Weill Cornell Medical College, New York, NY; and Department of Neurology (N.D.S.), New York Presbyterian Hospital.
罗伯特·d·史蒂文斯
从神经学和急性Ne首页urorehabilitation单元(降低价格,I.A.M.,J.J.,P.R.), Department of Clinical Neurosciences, and Department of Radiology (V.D., P.P.), Lausanne University Hospital and University of Lausanne; University Hospital of Old Age Psychiatry (I.A.M.), University of Bern, Switzerland; Neurology Unit (A.P.), Department of Medicine, Hôpitaux Robert Schuman, Luxembourg; Department of Neuroscience (D.F.M.), Luliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery (R.D.S.), School of Medicine, Johns Hopkins University, Baltimore, MD; Feil Family Brain and Mind Research Institute (N.D.S.), Weill Cornell Medical College, New York, NY; and Department of Neurology (N.D.S.), New York Presbyterian Hospital.
尼古拉斯·d·希夫
从神经学和急性Ne首页urorehabilitation单元(降低价格,I.A.M.,J.J.,P.R.), Department of Clinical Neurosciences, and Department of Radiology (V.D., P.P.), Lausanne University Hospital and University of Lausanne; University Hospital of Old Age Psychiatry (I.A.M.), University of Bern, Switzerland; Neurology Unit (A.P.), Department of Medicine, Hôpitaux Robert Schuman, Luxembourg; Department of Neuroscience (D.F.M.), Luliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery (R.D.S.), School of Medicine, Johns Hopkins University, Baltimore, MD; Feil Family Brain and Mind Research Institute (N.D.S.), Weill Cornell Medical College, New York, NY; and Department of Neurology (N.D.S.), New York Presbyterian Hospital.
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文摘
脑损伤病人的认知电动机离解(CMD)表现出缺乏命令后,使用传统的神经行为检测工具,但高水平的意识和语言处理时使用先进的成像和电生理学技术评估。因为他们的行为反应迟钝,CMD病人似乎临床区别那些真正的意识障碍影响意识很大程度上(昏迷,植物人状态/反应迟钝的清醒状态,或最小意识状态-)。然而,通过扩大电机测试的范围在四肢,面部,眼部motricity,我们可能会发现微妙,即使是在有目的的运动分为植物人的子集/反应迟钝的清醒状态。我们建议临床CMD的术语来描述病人显示这些轻微但坚定的运动响应和展示特点无着丝粒的运动行为与锥体运动系统的行为。这些病人可能港隐藏的认知能力和巨大的潜力良好的长期结果。确实,我们设想CMD从完整(无运动反应)部分(微妙的临床运动反应)的形式,范围内逐步下降患者更好的运动输出大量的认知能力。除了提供一个决策流程图,我们介绍这本小说分类方法作为一种图形化的模型,说明了各种临床表现和复苏轨迹从根本上区分真正的意识障碍从CMD的光谱。
术语表
- AIE=
- 先进的成像和电生理学技术;
- CMD=
- 认知汽车离解;
- CRS-R=
- 昏迷恢复量表——;
- MBT-r=
- 运动行为Tool-Revised
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作者回复:专注于微妙的迹象和运动行为推出没有响应从患者的意识:在临床的重要性
- 伊。迈耶,神经学家,洛桑大学医院
- 简Johr,神经心理学家,洛桑大学医院
- 卡琳Diserens,神经学家,洛桑大学医院
2023年3月23日提交 -
读者反应:专注于微妙的迹象和运动行为推出没有响应从患者的意识:在临床的重要性
- 卡利斯托马查多,完整的神经学教授和研究员首页,神经病学与神经外科研究所的首页临床神经生理学,古巴哈瓦那
2023年3月04,提交
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