Clinical management of the minimally conscious state

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


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.

Keywords: assessment; brain injury; diagnosis; minimally conscious state; rehabilitation.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Disease Management*
  • Humans
  • Persistent Vegetative State / diagnosis*
  • Persistent Vegetative State / therapy*
  • Practice Guidelines as Topic*