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Handb Clin Neurol. 2015;127:395-410. doi: 10.1016/B978-0-444-52892-6.00025-8.

Clinical management of the minimally conscious state.

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Park Terrace Care Center, Rego Park, NY, USA.
Department of Physical Medicine and Rehabilitation, Harvard Medical School and Spaulding Rehabilitation Hospital, Boston, MA, USA. Electronic address:


The minimally conscious state (MCS) was defined as a disorder of consciousness (DoC) distinct from the vegetative state more than a decade ago. While this condition has become widely recognized, there are still no guidelines to steer the approach to assessment and treatment. The development of evidence-based practice guidelines for MCS has been hampered by ambiguity around the concept of consciousness, the lack of accurate methods of assessment, and the dearth of well-designed clinical trials. This chapter provides a critical review of existing assessment procedures, critically reviews available treatment options and identifies knowledge gaps. We close with practice-based recommendations for a rational approach to clinical management of this challenging population.


assessment; brain injury; diagnosis; minimally conscious state; rehabilitation

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