Minimally conscious state

The minimally conscious state is the next step in the patient’s recovery of consciousness. We say that a person is in a ‘minimally conscious state’ when his or her sensory and emotional responses to environmental stimuli display minimal but definite evidence of awareness of himself, herself, or the environment. A minimally conscious state may be permanent or may lead to a cognitive decline.

Patients should display at least one of the following behaviours:

  • Response to simple instructions
  • Verbal or non-verbal (gestures) and yes/no responses
  • Intelligible articulation of words
  • Location of painful stimuli
  • Goal-oriented behaviours, including congruent affective movements or responses to relevant visual or verbal stimuli
  • Responses to verbal questions using gestures or speech
  • Reaching for objects in the right direction and location
  • Touching or holding objects appropriately according to their shape or size
  • Sustaining visual gaze or following moving stimuli
  • Stereotyped movements (e.g., blinking or smiling) consistent with the stimulus

At the Nisa Hospitals Neurorehabilitation Unit, we specialize in the evaluation and treatment of patients with an altered state of consciousness (coma, vegetative state or unresponsive wakefulness syndrome, and minimally conscious state). In fact, our research team is conducting ongoing research into improving our understanding of the neural changes that occur between the coma state and the recovery of consciousness.

We have therefore developed a specific programme of therapy for patients with an altered state of consciousness. The programme includes a clinical and neurological evaluation as well as pharmacological treatment, multisensory and basal stimulation, physiotherapy and posture therapy, and stimulation of the orofacial muscles, among other treatments.

Our medical assistance for patients with an altered state of consciousness has recently been developed with the approval of the Federation of Brain Damage Associations (FEDACE). This collaboration has led to Spain’s first handbook on the unresponsive wakefulness syndrome and the minimally conscious state. The handbook provides the latest knowledge on diagnosing, evaluating, and treating patients with an altered state of consciousness. It also offers practical accounts from our health professionals based on their vast experience of treating patients with an altered state of consciousness (http://fedace.org/sindrome-de-vigilia-sin-respuesta-y-de-minima-con- ciencia-cuaderno-fedace-13/)