Sequence of Recovery During the Course of Emergence From the Minimally Conscious State

Taylor CM, Aird VH, Tate RL, Lammi MH. Sequence of recovery during the course of emergence from the minimally conscious state.ObjectiveTo document and examine recovery profiles of persons during the course of emergence from a minimally conscious state (MCS) after traumatic brain injury (TBI).DesignCase series.SettingParticipants in an inpatient brain injury rehabilitation program.ParticipantsNine people with TBI who emerged from MCS.InterventionsNot applicable.Main Outcome MeasureThe Western Neuro Sensory Stimulation Profile.ResultsIn all cases, stereotyped (nonreflexive) movement was the first behavior to resolve, yet by itself it was never sufficient to indicate emergence from the MCS. Two of the 9 patients showed consistent object manipulation before all 3 elements of functional communication. Conversely, in 2 patients, all 3 components of functional communication emerged before object manipulation. In the remaining 5 patients, object manipulation occurred along with components of functional communication.ConclusionsDuring the course of data collection, issues were raised about differentiation between the MCS and posttraumatic amnesia. The data are also discussed within the context of the work of Giacino et al and the development of their scale to measure duration of the MCS. These data support the theory that functional communication and object manipulation are the 2 key indicators of emergence from MCS.