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SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
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Psychogenic unresponsiveness.

Trevor A Hurwitz1

  • 1Division of Neurology, Department of Psychiatry and Medicine, University of British Columbia, Canada. t.hurwitz@ubc.ca

Neurologic Clinics
|October 29, 2011
PubMed
Summary
This summary is machine-generated.

Unresponsive patients, with or without catatonia, require neurodiagnostic assessment to exclude organic causes. Most cases stem from psychiatric disorders like mania, responding to lorazepam or electroconvulsive therapy.

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Area of Science:

  • Neurology
  • Psychiatry

Background:

  • Unresponsive patients with catatonia present diagnostic challenges.
  • Etiology is heterogeneous, necessitating thorough neurodiagnostic evaluation.

Purpose of the Study:

  • To outline the diagnostic and therapeutic approach for unresponsive patients, including those with catatonic features.
  • To differentiate primary psychiatric disorders from organic causes.

Main Methods:

  • Comprehensive neurodiagnostic assessment to identify organic etiologies.
  • Clinical observation and response to pharmacological and non-pharmacological interventions.

Main Results:

  • Most unresponsive patients, including those with catatonia, have primary psychiatric disorders, predominantly mood disorders like mania.
  • Patients generally respond to lorazepam or electroconvulsive therapy (ECT).
  • Fever and autonomic instability indicate medical emergencies requiring immediate intervention.

Conclusions:

  • A systematic approach is crucial for managing unresponsive patients.
  • Early diagnosis and treatment of underlying psychiatric conditions improve outcomes.
  • Prompt recognition of medical emergencies in this population is vital.