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Updated: Sep 29, 2025
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Assessment and Communication for People with Disorders of Consciousness
Published on: August 1, 2017
9.3K
Pain in Persons with Disorders of Consciousness
Nathan D Zasler1,2, Rita Formisano3, Marta Aloisi3
1Concussion Care Centre of Virginia, LTD, Henrico, VA 23233, USA.
Brain Sciences
|March 25, 2022
Summary
Pain and suffering in individuals with disorders of consciousness (DoC) are complex and often overlooked. This review explores pain assessment, management, and ethical issues in DoC patients.
Area of Science:
- Neurology
- Pain Medicine
- Rehabilitation Medicine
Background:
- Pain and suffering in disorders of consciousness (DoC) are poorly understood and inadequately addressed.
- Significant controversy exists regarding pain perception and management in this patient population.
Purpose of the Study:
- To provide a comprehensive overview of pain and suffering in patients with DoC.
- To review current knowledge on pain pathoanatomy, pathophysiology, common pain generators, and pain chronification.
- To explore challenges in pain assessment, electrophysiologic and neuroimaging findings, pain management strategies, and ethical considerations.
Main Methods:
- This study is a narrative literature review.
- It synthesizes existing research on pain in disorders of consciousness.
Main Results:
- Pain in DoC is complex, involving pathoanatomy, pathophysiology, and chronification factors.
- Bedside assessment presents challenges, necessitating exploration of electrophysiologic and neuroimaging data.
- Both non-pharmacological and pharmacological pain management techniques are reviewed, alongside critical ethical considerations.
Conclusions:
- Addressing pain and suffering in DoC requires a multidisciplinary approach.
- Improved understanding and management strategies are crucial for patient well-being.
- Ethical considerations must guide all aspects of care for individuals with DoC experiencing pain.
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