Attitudes towards Personhood in the Locked-in Syndrome: from Third- to First- Person Perspective and to Interpersonal Significance
AbstractPersonhood is ascribed on others, such that someone who is recognized to be a person is bestowed with certain civil rights and the right to decision making. A rising question is how severely brain-injured patients who regain consciousness can also regain their personhood. The case of patients with locked-in syndrome (LIS) is illustrative in this matter. Upon restoration of consciousness, patients with LIS find themselves in a state of profound demolition of their bodily functions. From the third-person perspective, it can be expected that LIS patients might experience a differential personal identity and may lose...
Source: Neuroethics - July 13, 2018 Category: Medical Ethics Source Type: research
Brain Death: Diagnosis and Imaging Techniques
Publication date: Available online 2 March 2018Source: Seminars in Ultrasound, CT and MRIAuthor(s): Tanvir Rizvi, Prem Batchala, Sugoto MukherjeeBrain death (BD) is an irreversible cessation of functions of the entire brain, including the brainstem. The diagnosis of BD is made on clinical grounds and neurologic examination. In the United States, clinical criteria set by the American Academy of Neurology (AAN) emphasize 3 specific clinical findings to confirm BD, which include coma, absence of brainstem reflexes and apnea. Ancillary tests are needed when neurologic examination or apnea test cannot be performed. AAN recommen...
Source: Seminars in Ultrasound, CT and MRI - July 10, 2018 Category: Radiology Source Type: research
Phenomenological Analysis of a Japanese Professional Caregiver Specialized in Patients with Amyotrophic Lateral Sclerosis
AbstractThe present article is based on a interview with a Japanese experienced caregiver who specializes in patients with amyotrophic lateral sclerosis (ALS), which generally leads to the locked-in syndrome (LIS). Professional caregivers for ALS patients with ventilator experience two particular temporalities in their practice. First, they must monitor the patient continuously during a seven-hour stay. Because a single problem in the ventilator can have fatal consequences, the care of an ALS patient with a ventilator (who can neither speak nor push the nurse call button) requires long periods of sustained concentration. S...
Source: Neuroethics - July 5, 2018 Category: Medical Ethics Source Type: research
Locked-in syndrome responding to thrombolytic therapy
We present a case of a 70-year-old female who presented to our emergency department after developing respiratory distress followed by sudden unresponsiveness. She was diagnosed with LIS and had an immediate and remarkable improvement after administration of tissue plasminogen activator (TPA). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - July 2, 2018 Category: Emergency Medicine Authors: Thomas M. Johnson, Cynthia S. Romero, Austin T. Smith Source Type: research
Locked-in syndrome in post snake bite: can it be unlocked?
PMID: 30005589 [PubMed - in process] (Source: Tropical Doctor)
Source: Tropical Doctor - July 1, 2018 Category: Tropical Medicine Authors: Senthilkumaran S, Balamurugan N, Nath Jena N, Thirumalaikolundusubramanian P Tags: Trop Doct Source Type: research
A History of the Locked-In-Syndrome: Ethics in the Making of Neurological Consciousness, 1880-Present
AbstractExtensive scholarship has described the historical and ethical imperatives shaping the emergence of the brain death criteria in the 1960s and 1970s. This essay explores the longer intellectual history that shaped theories of neurological consciousness from the late-nineteenth century to that period, and argues that a significant transformation occurred in the elaboration of those theories in the 1960s and after, the period when various disturbances of consciousness were discovered or thoroughly elaborated. Numerous historical conditions can be identified and attributed to the production of the new theories that eme...
Source: Neuroethics - June 19, 2018 Category: Medical Ethics Source Type: research
Cortical Brain Changes in Patients With Locked-In Syndrome Experiencing Hallucinations and Delusions
Marco Sar à, Riccardo Cornia, Massimiliano Conson, Antonio Carolei, Simona Sacco, Francesca Pistoia (Source: Frontiers in Neurology)
Source: Frontiers in Neurology - May 17, 2018 Category: Neurology Source Type: research
Feasibility of an EEG-based brain-computer interface in the intensive care unit.
CONCLUSIONS: The system is feasible to deploy in the ICU and may confirm consciousness in acute LIS, but it was unreliable in acute DoC.
SIGNIFICANCE: The accuracy of the paradigms for detecting consciousness must be improved and the duration of the protocol should be shortened before this commercially available BCI is ready for clinical implementation in the ICU in patients with acute DoC.
PMID: 29804044 [PubMed - as supplied by publisher] (Source: Clinical Neurophysiology)
Source: Clinical Neurophysiology - May 9, 2018 Category: Neurology Authors: Chatelle C, Spencer CA, Cash SS, Hochberg LR, Edlow BL Tags: Clin Neurophysiol Source Type: research
Medical Decision Making by Patients in the Locked-in Syndrome
AbstractThe locked-in syndrome (LIS) is a state of profound paralysis with preserved awareness of self and environment who typically results from a brain stem stroke. Although patients in LIS have great difficulty communicating, their consciousness, cognition, and language usually remain intact. Medical decision-making by LIS patients is compromised, not by cognitive impairment, but by severe communication impairment. Former systems of communication that permitted LIS patients to make only “yes” or “no” responses to questions was sufficient to validate their consent for simple medical decisions but not for conseque...
Source: Neuroethics - March 14, 2018 Category: Medical Ethics Source Type: research
Are You There? The Growing Need to Get the Right Diagnosis in Disorder of Consciousness
Disorder of consciousness (DOC) can be either an acute and reversible condition or a chronic condition, including vegetative state or minimally conscious state. Herein, we describe a patient who has unexpectedly recovered consciousness after being in a misdiagnosed vegetative state for a long period. A 63-year-old woman was admitted to our rehabilitation center in vegetative state (Coma Recovery Scale-Revised score, 6) and treated with a standard rehabilitation program, including physical therapy and multisensory stimulation, besides psychoactive drugs. After 26 months of such training, she progressively presented with une...
Source: Journal of Neuroscience Nursing - March 13, 2018 Category: Neuroscience Tags: Case Study Source Type: research
Brain Death: Diagnosis and Imaging Techniques
Publication date: Available online 2 March 2018 Source:Seminars in Ultrasound, CT and MRI Author(s): Tanvir Rizvi, Prem Batchala, Sugoto Mukherjee Brain death (BD) is an irreversible cessation of functions of the entire brain, including the brainstem. The diagnosis of BD is made on clinical grounds and neurologic examination. In the United States, clinical criteria set by the American Academy of Neurology (AAN) emphasize 3 specific clinical findings to confirm BD, which include coma, absence of brainstem reflexes and apnea. Ancillary tests are needed when neurologic examination or apnea test cannot be performed. AAN r...
Source: Seminars in Ultrasound, CT and MRI - March 13, 2018 Category: Radiology Source Type: research
A Human–Humanoid Interaction Through the Use of BCI for Locked-In ALS Patients Using Neuro-Biological Feedback Fusion
This paper illustrates a new architecture for a human–humanoid interaction based on EEG-brain computer interface (EEG-BCI) for patients affected by locked-in syndrome caused by Amyotrophic Lateral Sclerosis (ALS). The proposed architecture is able to recognise users’ mental state accordingly to the biofeedback factor $text {B}_{text f}$ , based on users’ attention, intention, and focus, that is used to elicit a robot to perform customised behaviours. Experiments have been conducted with a population of eight subjects: four ALS patients in a near locked-in status with normal ocular movement and four hea...
Source: IEE Transactions on Neural Systems and Rehabilitation Engineering - February 1, 2018 Category: Neuroscience Source Type: research
