Diagnosis, prognosis and treatment in disorders of consciousness

peer reviewedAdvances in medicine and intensive care have led to an increase in the number of patients surviving a severe brain injury. Although some patients recover quickly, others remain in a state of altered consciousness. These patients can progress from a coma to a vegetative state or unresponsive wakefulness syndrome (VS/UWS) and later to a minimally conscious state (MCS). In this review, we first describe the different behavioral and neuroimaging methods used in the diagnosis of patients in an altered state of consciousness. We then describe the factors that can influence the prognosis and recovery of these patients, as well as the treatment and therapeutic management that can be proposed in order to improve their state of consciousness. Finally, we conclude this review by highlighting ethical considerations and end-of-life issues. © 2017 Elsevier Masson SAS