Clinical application of recommendations for neurobehavioral assessment in disorders of consciousness: an interdisciplinary approach

Accurate diagnosis, prognosis, and subsequent rehabilitation care planning for persons with Disorders of Consciousness (DoC) has historically posed a challenge neurological professionals. Evidence suggests rates misdiagnosis may be as high 40% when informal beside evaluations are used to determine level consciousness. The presence myriad medical, neurological, functional (motor, sensory, cognitive) environmental confounds germane these conditions complicates behavioral assessment. Achieving diagnostic certainty is elusive but critical inform planning, clinical decision making, prognostication. Standardized neurobehavioral rating scales been shown improve accuracy in distinguishing between coma, unresponsive wakefulness syndrome/vegetative state minimally consciousness compared assessment methods. Thus, currently recommended use the “gold standard” DoC. following paper will present an evidence-based approach practice. Strategies optimizing aiding identification management that can limit provided. Finally, application interdisciplinary identifying managing discussed how results identify trends performance guide prognostic counseling families.