Probing consciousness in a sensory-disconnected paralyzed patient

Brain Inj. 2017;31(10):1398-1403. doi: 10.1080/02699052.2017.1327673. Epub 2017 Jun 28.

Abstract

Background: Diagnosis of consciousness can be very challenging in some clinical situations such as severe sensory-motor impairments.

Case study: We report the case study of a patient who presented a total "locked-in syndrome" associated with and a multi-sensory deafferentation (visual, auditory and tactile modalities) following a protuberantial infarction.

Result: In spite of this severe and extreme disconnection from the external world, we could detect reliable evidence of consciousness using a multivariate analysis of his high-density resting state electroencephalogram. This EEG-based diagnosis was eventually confirmed by the clinical evolution of the patient.

Conclusion: This approach illustrates the potential importance of functional brain-imaging data to improve diagnosis of consciousness and of cognitive abilities in critical situations in which the behavioral channel is compromised such as deafferented locked-in syndrome.

Keywords: brain functional imagery; consciousness; disorder of consciousness; locked-in syndrome; quantitative EEG.

Publication types

  • Case Reports

MeSH terms

  • Brain / physiopathology*
  • Consciousness Disorders / diagnosis*
  • Consciousness Disorders / physiopathology
  • Electroencephalography
  • Functional Neuroimaging
  • Humans
  • Male
  • Middle Aged
  • Quadriplegia / physiopathology*