ABSTRACT
This chapter describes some of the most common and effective interventions in disorders of consciousness (DOC) patients. Diagnosis currently depends on behavioural assessment, which is prone to misdiagnosis. Regardless of diagnosis, clinical management of patients with disorders of consciousness is challenging. Pain management, physiotherapy and speech therapy are essential to optimise the patient's condition. The Full Outline of Unresponsiveness (FOUR) scale seems more appropriate for DOC patients as it assesses visual pursuit, one of the first signs of recovering consciousness. The assessor observes the patient's spontaneous behaviour and explains the aim of the assessment, emphasising the importance of full collaboration. A correlation was found between Nociception Coma Scale-Revised (NCS-R) score and glucose metabolism in the posterior part of the anterior cingulate cortex, suggesting that the scale is valid to assess nociception in DOC patients. It has been suggested that music therapy and stimulating the patient with emotional input could promote re-emergence of consciousness in DOC patients.
