The article is professionally consulted by Master, Doctor Phan Ngoc Toan – Emergency Medicine Doctor – Emergency Department – Vinmec Danang International Hospital. The doctor has a lot of experience in the treatment of Resuscitation – Emergency.

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Perception is a psychological process, capable of gathering individual characteristics of things and phenomena, which are reflected by the senses in a unified and complete objective way. Perceptual disturbances are common, it always signals a disease of the nervous system.

Disturbance of consciousness / Disturbance of consciousness, or impairment of consciousness, is a state in which consciousness is affected due to brain damage. Consciousness requires both wakefulness and awareness. Awakening is the ability to open the eyes and have basic reflexes such as coughing, swallowing, and sucking/sucking Perception is associated with thought processes more complex and difficult to evaluate. Currently, cognitive assessments are based on physical responses detected during tests.

There are many classifications, but the main disorders of consciousness are:

Coma Vegetative state Minimal conscious state

Some other conditions:

Locked-in syndrome Brain death (separate post)

Overdosing on stimulants can cause confusion

2. Coma

A state when a person shows no signs of being awake and shows no signs of recognition. A comatose person lies with their eyes closed and unresponsive to environment, voice, or painful stimuli. Coma usually lasts less than 2 to 4 weeks, during which time a person may wake up or go into a vegetative or minimally conscious state.

Hallucinations appear not due to the subjective will of the patient

3. Vegetative state

The vegetative state is when a person awakens but has no signs of awareness

A person in a vegetative state can:

Open their eyes Wake up and go to sleep at regular intervals Have basic reflexes (such as blinking when they’re startled by loud noises or pulling their hands away when squeezed hard)

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They can also regulate heart rate and breathing without assistance.

But a person in a vegetative state does not show any meaningful responses, such as following objects with their eyes or responding to voices. They also have no expression of emotions.

If a person is in a vegetative state for a long time, it can be considered as:

Persistent vegetative state if lasting more than 4 weeks

If a person is diagnosed as being in a permanent vegetative state, recovery is extremely unlikely but not impossible.

Hallucinations are often repeated and haunt the patient

4. Minimal state of consciousness

A person who exhibits clear but minimal or inconsistent awareness is classified as a minimally conscious state. They may have periods when they are able to communicate or respond to requests, such as finger movements when asked. A person may enter a minimally conscious state after a coma or a vegetative state. In some cases, the minimally conscious state is a stage on the road to recovery, but in other cases it is permanent.

Like the vegetative state, the minimally conscious state is continuous meaning it lasts more than 4 weeks.

But it’s harder to diagnose a permanent minimal state of consciousness because it depends on things like:

Type of brain damageHow severe the damageHow does the person react

In most cases, a minimally conscious state is not considered permanent until it has lasted several years.

5. Why is there a disorder of consciousness

Disturbances of consciousness can occur if parts of the brain involved in consciousness are damaged.

These types of brain injuries can be divided into: Traumatic brain injury- the result of a serious head injury, such as trauma from a car accident or a fall from a great height…Non-related brain injury trauma: stroke, infection… Progressive brain damage: gradual brain damage over time (eg, due to Alzheimer’s disease)

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6. Locked-in syndrome

Usually due to pontine hemorrhage or infarction, it causes quadriplegia, disruption and damage to the lower cranial nerves and the centers that control the horizontal vision. The patient has intact cognitive function and is awake. apple, eye opening, and normal sleep-wake cycle. They can hear and see. However, they cannot move the lower face, chew, swallow, speak, breathe through the mouth, move the limbs or glance sideways but can move the eyes vertically, the patient can open and close the eyes or blink some specific times to answer the question.

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7. Diagnosis

Disturbance of consciousness will only be confirmed after a full assessment is made to determine the person’s level of alertness and awareness. These tests should be performed by someone with experience with disturbances of consciousness. , although the views of other health care professionals and members Family members should also be considered. For some states of impaired consciousness, such as vegetative states and minimally conscious states, there are recommended criteria to help confirm the diagnosis.

8. Treatment and care

Treatment does not guarantee recovery of impaired consciousness.

Instead, supportive treatment is used to give the best chance of natural improvement.

This may be related to:

Provide nutrition through a feeding tube (gastric tube)Make sure the patient doesn’t have pressure ulcers (tilts, massage, etc.) Prevent stiffness Keep skin clean Take care of the intestines and bladder (eg. bladder) Keep teeth and mouth clean Create opportunities for meaningful activity time – such as listening to music or watching television, seeing pictures or hearing family members talk.

9. Sensory stimulation

In some cases, a treatment called sensory stimulation may be used to try to increase responsiveness. This involves stimulating the primary senses, such as sight, hearing, and smell. This is usually done by a trained professional, but family members are often encouraged to participate.

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Some examples of sensory stimulation include:

See – show photos of friends and family or a favorite movie Listen – speak or play a favorite song Smell – place flowers in the room or spray on their favorite perfume Touch – clasp their hands or stroke their skin with various kinds different fabric

It’s not entirely clear how effective sensory stimulation is, but it’s sometimes considered worthwhile.

10. Recovery

It is not possible to predict how likely someone with impaired consciousness will be to improve.

It mainly depends on:

Type of brain damageSeverity of injuryAge Duration of illness

Some patients improve gradually, while others remain in a state of impaired consciousness for many years. Many people never regain consciousness. Only in isolated cases regain consciousness after several years. A small number of patients who wake up after this time often have severe disabilities due to brain damage.

The Psychology Clinic has been operating since April 2019. The clinic has the function of examining, consulting and outpatient treatment of psychological and mental health problems.

With modern equipment and a team of doctors who are lecturers in psychiatry at Hanoi Medical University, the Psychology Clinic – Vinmec Times City International Hospital is capable of implementing psychological tests. , specialized psychotherapy for medical examination and treatment.

Customers can go directly to Vinmec Times City to visit or contact hotline 0243 9743 556 for support.

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