The subject of the apallic syndrome is one which has long been familiar to me, although I have not personally studied it as deeply as I would have wished. I became acquainted with this syndrome long before the last war, when my neurosurgical colleague Hugh Cairns (1952), made his pioneer contribution under the term "akinetic mutism" . This was an ar resting title, but it was one which did not altogether satisfy some of his colleagues, includ ing myself. We found it difficult to suggest an alternative. That is one reason why I wel come the expression "apallic syndrome" . Forensic practice has forced me from time to time to consider rather more deeply this distressing syndrome, and to try and marshal my ideas in a form which would satisfy my colleagues in the legal profession. More than once I have been instructed to make a medico legal assessment of these unfortunate patients. The points which have concerned my lawyer friends have not been matters of diagnosis, or of morbid anatomy, or of etiology. The fac tual problem which has been put before me was to make some approximate assessment as to the expectation of life. Vague guess-work is unacceptable in such circumstances. What the lawyers require is a precise and dogmatic answer.

A survey of the medical, ethical and legal issues that surround this controversial topic.

The care of stroke patients has changed dramatically. As well as improvements in the emergency care of the condition, there have been marked advances in our understanding, management and rehabilitation of residual deficits. This book is about the care of stroke patients, focusing on behavioural and cognitive problems. It provides a comprehensive review of the field covering the diagnostic value of these conditions, in the acute and later phases, their requirements in terms of treatment and management and the likelihood and significance of long-term disability. This book will appeal to all clinicians involved in the care of stroke patients, as well as to neuropsychologists, other rehabilitation therapists and research scientists investigating the underlying neuroscience.

This open access book focuses on practical clinical problems that are frequently encountered in stroke rehabilitation. Consequences of diseases, e.g. impairments and activity limitations, are addressed in rehabilitation with the overall goal to reduce disability and promote participation. Based on the available best external evidence, clinical pathways are described for stroke rehabilitation bridging the gap between clinical evidence and clinical decision-making. The clinical pathways answer the questions which rehabilitation treatment options are beneficial to overcome specific impairment constellations and activity limitations and are well acceptable to stroke survivors, as well as when and in which settings to provide rehabilitation over the course of recovery post stroke. Each chapter starts with a description of the clinical problem encountered. This is followed by a systematic, but concise review of the evidence (RCTs, systematic reviews and meta-analyses) that is relevant for clinical decision-making, and comments on assessment, therapy (training, technology, medication), and the use of technical aids as appropriate. Based on these summaries, clinical algorithms / pathways are provided and the main clinical-decision situations are portrayed. The book is invaluable for all neurorehabilitation team members, clinicians, nurses, and therapists in neurology, physical medicine and rehabilitation, and related fields. It is a World Federation for NeuroRehabilitation (WFNR) educational initiative, bridging the gap between the rapidly expanding clinical research in stroke rehabilitation and clinical practice across societies and continents. It can be used for both clinical decision-making for individuals and as well as clinical background knowledge for stroke rehabilitation service development initiatives.

This serial is firmly established as an extensive documentation of the advances in contemporary brain research. Each volume presents authoritative reviews and original articles by invited specialists.This volume concentrates on coma and consciousness science. presenting articles from leading figures in the area on the clinical and ethical implications of work in this field. The book provides a thorough review of the various aspects of coma science from a review of the concepts, questioning of recent advances, case studies, through to where research in the field is heading. - Provides the reader with a unique overview of all aspects of new advances in coma science - Broad focus with contributions by the top scientists worldwide in the respective disciplines

Many patients experience sleep disturbances secondary to their primary illness and this often has a negative effect on their quality of life. This book provides an evidence-based introduction to the interface between sleep wide range of medical disorders. A clinically focused, comprehensive review for physicians and other health providers, this state-of-the-art reference can also serve as a textbook for those who wish to become familiar with the impact of sleep on quality of life.

Table of Contents Table of Boxes Preface Explanatory Notes Chapter 1 Diagnosis of Neurological Diseases (General Principle) Chapter 2 History Taking Chapter 3 Physical Examination Chapter 4 Evaluation of Consciousness Chapter 5 Brainstem and Cranial Nerve Territories Chapter 6 Olfactory Sensation Chapter 7 Visual Functions Chapter 8 Pupils and Accommodation Chapter 9 Extraocular Muscles, Gaze, and Eye Movements Chapter 10 Trigeminal Nerve Chapter 11 Facial Nerve Chapter 12 Auditory Function Chapter 13 Sense of Equilibrium Chapter 14 Swallowing, Phonation, and Articulation Chapter 15 Neck and Trunk Chapter 16 Motor Functions Chapter 17 Tendon Reflexes and Pathologic Reflexes Chapter 18 Involuntary Movements Chapter 19 Somatosensory Function Chapter 20 Autonomic Nervous System Chapter 21 Posture and Gait Chapter 22 Mental and Cognitive Functions Chapter 23 Aphasia, Apraxia, and Agnosia Chapter 24 Paroxysmal and Functional Disorders Chapter 25 Ion Channel Disorders Chapter 26 Psychogenic Neurological Diseases Chapter 27 Thalamus Chapter 28 Hypothalamus and Neuroendocrinology Chapter 29 Neurological Emergency Chapter 30 Disability, Functional Recovery, and Prognosis Chapter 31 How to Plan Laboratory Tests Afterword: For Those Who Wish to Study Neurology.

Updated and revised, the highly-anticipated second edition of The Blackwell Companion to Consciousness offers a collection of readings that together represent the most thorough and comprehensive survey of the nature of consciousness available today. Features updates to scientific chapters reflecting the latest research in the field Includes 18 new theoretical, empirical, and methodological chapters covering integrated information theory, renewed interest in panpsychism, and more Covers a wide array of topics that include the origins and extent of consciousness, various consciousness experiences such as meditation and drug-induced states, and the neuroscience of consciousness Presents 54 peer-reviewed chapters written by leading experts in the study of consciousness, from across a variety of academic disciplines

Unique case-based guide to generating diagnostic possibilities based on the patients' symptoms. Invaluable for psychiatrists and neurologists.

The Comatose Patient, Second Edition, is a critical historical overview of the concepts of consciousness and unconsciousness, covering all aspects of coma within 100 detailed case vignettes. This comprehensive text includes principles of neurologic examination of comatose patients as well as instruction of the FOUR Score coma scale, and also discusses landmark legal cases and ethical problems. As the Chair of Division of Critical Care Neurology at Mayo Clinic, Dr. Wijdicks uses his extensive knowledge to discuss a new practical multistep approach to the diagnosis of the comatose patient. Additionally, this edition includes extensive coverage of the interpretation of neuroimaging and its role in daily practice and decision making, as well as management in the emergency room and ICU. Dr. Wijdicks details long-term supportive care and an appropriate approach to communication with family members about end-of-life decision making. In addition, video clips on neurologic examination and neurologic manifestations seen in comatose patients can be found here: http://oxfordmedicine.com/comatosepatient2e. All video recordings from the first edition have been reformatted and remastered for optimal use, and several more video clips of patients have also been included.