Recent advances in medicine for resuscitation and care have led to an increased number of patients that survive severe brain damage but who are poorly responsive and non-communicative at the bedside. This has led to a striking need to better characterize, understand, and manage this population who present a real challenge for the assessment of pain and for planning treatment. This edited collection provides clinicians with a guide to recent developments in research on pain perception and assessment, and the detection of consciousness and communication in patients with disorders of consciousness (DOC).
With contributions from leading global researchers, the book gives an overview of issues concerning the assessment of pain. It also covers the development of suitable tools both to improve pain management and to detect consciousness and communication in these patients, to influence their prognosis and treatment, and their quality of life. Methodological and ethical issues concerning the implication for future research are also considered.
The book will be an invaluable guide for clinicians, medics and therapists working in rehabilitation and acute care, particularly in the demanding field of pain perception, pain assessment and detection of consciousness and communication in patients with DOC. It will also be useful for students and researchers in neuropsychology and medical sciences.
Table of Contents
1.Introduction to the challenge of pain and communication in disorders of consciousness, Camille Chatelle, Steven Laureys, Caroline Schnakers 2. The cortical processing of pain, André Mouraux 3. Behavioral assessment of pain in disorders of consciousness: clinical and ethical issues, Nathan D. Zasler, Anne T. O’Brien, and Caroline Schnakers 4. Overcoming the challenges of accurately assessing consciousness and communication in the context of pain assessment, John Whyte, & Mark Sherer 5. Using paraclinical assessments to detect consciousness and communicate with severely brain-injured patients, Camille Chatelle and Damien Lesenfants 6. Brain- Computer- Interface (BCI) Communication in the Locked- In: A Tool for Differential Diagnosis, Ujwal Chaudhary, Francesco Piccione and Niels Birbaumer 7. Disorders of Consciousness in an Evolving Neuroscience Context, Graham Wilson and Eric Racine 8. Conclusion and future perspectives, Camille Chatelle and Steven Laureys
Camille Chatelle is a postdoctoral research fellow at the Spaulding Rehabilitation Hospital Neurorehabilitation Laboratory, Harvard Medical School, USA. She is also working as a postdoctoral researcher at the Laboratory for NeuroImaging of Coma and Consciousness, Massachusetts General Hospital, Harvard Medical School, USA.
Steven Laureys leads the Coma Science Group at the Cyclotron Research Center and Department of Neurology, Sart Tilman Liège University Hospital, Belgium. He is Clinical Professor and Research Director at the Belgian National Fund of Scientific Research (FNRS).
‘This book provides an up-to date discussion of theoretical, scientific, clinical and ethical issues related to assessment and management of communication and pain in one of the most vulnerable patient groups in brain injury rehabilitation. A must have for researchers and practitioners who work with patients suffering disorders of consciousness’. - Marianne Løvstad, Sunnaas Rehabilitation Hospital and University of Oslo, Norway
‘In the absence of clear guidelines for the management of pain in disorders of consciousness, this book is a very helpful and important resource for all clinicians and researchers working in this field. It provides the reader with the state of the art in regard to diagnostic and treatment issues embedded in a larger context of the challenges and ethical dilemmas inherent in the clinical management of severely impaired non-communicative patients’. – Petra Maurer-Karattup, Clinic for Neurorehabilitation of Severe Head Injuries, SRH Fachkrankenhaus Neresheim, Germany