Consciousness disorder [Neurosurgery Wiki]

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====== Consciousness disorder ======

A [[disorder]] of [[consciousness]], or impaired consciousness, is a state where consciousness has been affected by damage to the brain. Consciousness requires both [[wakefulness]] and [[awareness]]. 

[[Amnesia]].

[[Coma]].

[[Confusion]].

[[Drowsiness]].

[[Loss of consciousness]] (LOC).

[[Minimally conscious state]]. 

[[Stupor]].
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High-[[cervical spinal cord stimulation]] can alter cortical activity and [[cerebral metabolism]]. These effects are potentially beneficial for disorders of consciousness. A better understanding of the effects of clinical application of stimulation is needed. Piedade et al. aimed to evaluate the existing [[literature]] to determine the state of available knowledge. They performed a [[literature review]] of clinical studies assessing cervical spinal cord [[epidural stimulation]] for disorders of consciousness. Only [[peer-review]]ed articles reporting preoperative and postoperative clinical status were included.

Nineteen studies were included. A total of 532 cases were reported, and 255 patients were considered responsive (47.9%). Considering only studies published after the definition of [[minimally conscious state]] (MCS) as an entity, 402 individuals in unresponsive wakefulness syndrome (UWS) and 113 in MCS were reported. Responsiveness to SCS was reported in 170 UWS patients (42.3%) and in 78 MCS cases (69.0%), although the criteria for responsiveness and outcome measures varied among publications.

Cervical SCS yielded encouraging results in patients with [[disorder]]s of [[consciousness]] and seems to be more effective in MCS. More extensive investigation is needed to understand its potential role in clinical practice
((Piedade GS, Assumpcao de Monaco B, Guest JD, Cordeiro JG. Review of spinal cord stimulation for disorders of consciousness. Curr Opin Neurol. 2023 Oct 27. doi: 10.1097/WCO.0000000000001222. Epub ahead of print. PMID: 37889524.))