Minimally conscious state

A minimally conscious state (MCS) is a condition distinct from coma or the vegetative state, in which a patient exhibits deliberate, or cognitively mediated, behavior often enough, or consistently enough, for clinicians to be able to distinguish it from entirely unconscious, reflexive responses.

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Patients with severe brain damage may progress through stages of unconsciousness with eyes closed (coma), to unconsciousness with eyes open (vegetative state), to a stage of "inconsistent, erratic responsiveness" (minimally conscious state). ^[1]

It is not known whether patients in MCS can process emotion. MCS is thought to have a more favorable outcome than persistent vegetative state.^[2]

Doctors in the USA recently succeeded in bringing a man who had been under MCS for six years back to consciousness by planting electrodes deep inside his brain. If the success can be more widely replicated, it offers hope for many of the up to 300,000 MCS sufferers in the USA today. ^[3]

Notable MCS patients

• Terry Wallis
• Gary Dockery
• Dorothy Crater

References

1. ^ Katz D I. "Minimally Conscious States". Kurzweilai.net, April 17, 2001
2. ^ Bekinschtein T, Niklison J, Sigman L, et al. "Emotion processing in the minimally conscious state". Journal of Neurology Neurosurgery and Psychiatry 2004;75:788
3. ^ "Electrodes stir man from six-year coma-like state", Cosmos Magazine, 02 August2007. 

Further reading

• Giacino JT, Ashwal S, Childs N, et al. "The minimally conscious state: definition and diagnostic criteria". Neurology 2002;58:349–53
• Boly M, Faymonville ME, Peigneux P, et al. "Auditory processing in severely brain injured patients: differences between the minimally conscious state and the persistent vegetative state". Archives of Neurology 2004;61:233–8.
• Hobson JA. "Consciousness as a state-dependent phenomenon". In Cohen JD, Schooler JW (eds). Scientific approaches to consciousness. Mahwah, NJ:Lawrence Earlbaum Assoc., 1997.
• Giacino JT, Kalmar K. "The vegetative and minimally conscious states: a comparison of clinical features and functional outcome." Journal of Head Trauma Rehabilitation 1997; 12: 36-51.
• Voss HU, et al. "Possible axonal regrowth in late recovery from the minimally conscious state." Journal of Clinical Investigation 2006 Jul;116(7):2005-2011
• Ford GP, Reardon DC. "Prolonged unintended brain cooling may inhibit recovery from brain injuries: case study and literature review." Med Sci Monit. 2006 Aug;12(8):CS74-9. Epub 2006 Jul 12. http://www.medscimonit.com/pub/vol_12/no_8/8795.pdf
• Emily Singer "Raising Consciousness" Technology Review Jan/Feb 2007