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Event Timing: 13 August 2019 at 16:30
Event Address: Nelson Mandela Children's Hospital
6 Jubilee Rd, Parktown, Johannesburg 2193
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 Lecture delivered by Professor Barbara A. Wilson
Assessment and Management of People With a Disorder of Consciousness (coma, vegetative state and minimally conscious state)
This presentation describes a number of studies looking at the assessment and treatment of people with Disorders of Consciousness (DOC). These include patients in coma, the vegetative state (VS) and the minimally conscious state (MCS). It is important to distinguish between these latter two states as referral decisions may well be different for the two groups. A new version of a measure to assess patients with DOC is described. The effects of posture on awareness is then considered. Provided medical conditions do not contra-indicate this, assessments should be carried out in an upright position as the majority of patients with DOC show more behaviours when assessed on a tilt table or standing frame. The third study looks at the effect of modafinil, an agent that maintains wakefulness and promotes attention and concentration, on levels of consciousness. Those with a traumatic brain injury (TBI) would appear to respond more to this than those whose DOC is caused by hypoxia.  The fourth study, compares the delayed recovery of two groups of patients, those with a TBI and those with hypoxic brain damage. Not surprisingly, those who showed delayed recovery of consciousness were far more likely to have sustained a TBI than hypoxic brain damage. The paper concludes with a case study of a man who had a DOC for 19 months, before regaining consciousness and proceeding to regain skills so that he is now leading a reasonable normal life.
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