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Antonio Incisa della Rocchetta

Wellington Hospital Acute Neurological Rehabilitation Unit, UK

Title: Prolonged disorders of consciousness- the assessment and therapy pathway

Biography

Biography: Antonio Incisa della Rocchetta

Abstract

The management of patients in a Prolonged Disorder of conciousness state is complex and most recent guidelines recommend that these patients are managed in a specialised unit by a specialist multi-disciplinary team. The Prolonged Disorders of Consciousness (PdoC) Unit at the Wellington Hospital was created according to these guidelines, to diagnose and treat patients with prolonged disorders of consciousness, aiming to optimise their care and management before discharge. The assessment and therapy pathway and its implementation will be presented including the internationally recommended assessment tools used. The processes for keeping the family involved and informed about diagnosis and prognosis, with advice about possible key decisions such as long-term care and the appropriateness of life-sustaining measures including antibiotics and resuscitation will also be highlighted. Functional imaging research has indicated that a sizeable proportion of patients (17-19 percent) diagnosed as lacking awareness with behavioural diagnostic tools are in fact aware. A programme of research and clinical assessment of level of consciousness is planned, utilising functional imaging techniques (fMRI and EEG) in order to identify these patients. The ethical implications of this will be discussed.