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Open Access 01-09-2018 | Review

Are visual functions diagnostic signs of the minimally conscious state? an integrative review

Authors: Berno U. H. Overbeek, Henk J. Eilander, Jan C. M. Lavrijsen, Raymond T. C. M. Koopmans

Published in: Journal of Neurology | Issue 9/2018

Abstract

Visual pursuit (VP) and visual fixation (VF) have been recognized as the first signs of emerging consciousness and, therefore, are considered indicative of the minimally conscious state (MCS). However, debate exists about their status as they are considered either conscious reactions or reflexes. The aim of this study is to review the evidence of the definition, operationalization, and assessment of VP and VF in unconscious patients. PubMed and EMBASE were searched for relevant papers between May 26, 1994 and October 1, 2016. In addition, an internet search was done to identify other relevant papers, reports and manuals of assessment methods. Papers were included if the definition, operationalization, or assessment method of VP and VF was discussed in patients with disorders of consciousness. We identified 2364 articles, of which 38 were included. No uniform definitions of VP and VF were found. VP and VF were operationalized differently, depending on which scale was used. The Coma Recovery Scale-revised and the Sensory Tool to Assess Responsiveness were the only diagnostic scales found; the other scales were developed to monitor DOC patients. The use of a mirror was the most sensitive method for detecting VP and VF. The literature about the importance VP and VF in relation with consciousness is controversial. This integrative review shows a lack of consensus regarding the definition, operationalization, and assessment of VP and VF. International consensus development about the definition, operationalization, and assessment of VP and VF is recommended.

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We will use the term visual pursuit. When we refer to a specific paper, we will use the terminology mentioned in that paper.

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Title: Are visual functions diagnostic signs of the minimally conscious state? an integrative review
Authors: Berno U. H. Overbeek
Henk J. Eilander
Jan C. M. Lavrijsen
Raymond T. C. M. Koopmans
Publication date: 01-09-2018
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 9/2018
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-018-8788-9

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Springer Medicine

Are visual functions diagnostic signs of the minimally conscious state? an integrative review

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