Minimally conscious state

Minimally Conscious State (MCS) is a disorder of consciousness distinct from persistent vegetative state and locked-in syndrome. Unlike the persistent vegetative state, patients with MCS have partial preservation of conscious awareness. MCS is a relatively new category of disorders of consciousness, first defined in 2002.

Definition

The Multi-Society Task Force on PVS has defined MCS as a condition of severely altered consciousness in which minimal but definite behavioral evidence of self or environmental awareness is demonstrated. This is in contrast to coma and vegetative state.

Diagnosis

Diagnosis of MCS is challenging, as it relies on an absence of a consistent command following, but a presence of reproducible or sustained behaviors that occur in response to stimuli. These behaviors can be visual, auditory, tactile, or noxious and must be reproducible or sustained over time.

Treatment

There is no specific treatment or cure for MCS. Management is supportive and rehabilitative, focusing on prevention of complications (such as pneumonia, pressure ulcers, and contractures), provision of adequate nutrition, and physical, occupational, and speech therapy.

Prognosis

The prognosis of patients with MCS is difficult to determine. Some patients may improve with time, while others may remain in a minimally conscious state for years or even decades. The longer a patient is in MCS, the less likely they are to recover full consciousness, although exceptions to this general rule have been reported.

See also

• Coma
• Vegetative state
• Locked-in syndrome
• Brain death

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