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Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review

The assessment and management of pain and nociception is very challenging in patients unable to communicate functionally such as patients with disorders of consciousness (DoC) or in locked-in syndrome (LIS). In a clinical setting, the detection of signs of pain and nociception by the medical staff i...

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Autores principales: Bonin, Estelle A. C., Lejeune, Nicolas, Szymkowicz, Emilie, Bonhomme, Vincent, Martial, Charlotte, Gosseries, Olivia, Laureys, Steven, Thibaut, Aurore
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10067681/
https://www.ncbi.nlm.nih.gov/pubmed/37021037
http://dx.doi.org/10.3389/fnsys.2023.1112206
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author Bonin, Estelle A. C.
Lejeune, Nicolas
Szymkowicz, Emilie
Bonhomme, Vincent
Martial, Charlotte
Gosseries, Olivia
Laureys, Steven
Thibaut, Aurore
author_facet Bonin, Estelle A. C.
Lejeune, Nicolas
Szymkowicz, Emilie
Bonhomme, Vincent
Martial, Charlotte
Gosseries, Olivia
Laureys, Steven
Thibaut, Aurore
author_sort Bonin, Estelle A. C.
collection PubMed
description The assessment and management of pain and nociception is very challenging in patients unable to communicate functionally such as patients with disorders of consciousness (DoC) or in locked-in syndrome (LIS). In a clinical setting, the detection of signs of pain and nociception by the medical staff is therefore essential for the wellbeing and management of these patients. However, there is still a lot unknown and a lack of clear guidelines regarding the assessment, management and treatment of pain and nociception in these populations. The purpose of this narrative review is to examine the current knowledge regarding this issue by covering different topics such as: the neurophysiology of pain and nociception (in healthy subjects and patients), the source and impact of nociception and pain in DoC and LIS and, finally, the assessment and treatment of pain and nociception in these populations. In this review we will also give possible research directions that could help to improve the management of this specific population of severely brain damaged patients.
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spelling pubmed-100676812023-04-04 Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review Bonin, Estelle A. C. Lejeune, Nicolas Szymkowicz, Emilie Bonhomme, Vincent Martial, Charlotte Gosseries, Olivia Laureys, Steven Thibaut, Aurore Front Syst Neurosci Neuroscience The assessment and management of pain and nociception is very challenging in patients unable to communicate functionally such as patients with disorders of consciousness (DoC) or in locked-in syndrome (LIS). In a clinical setting, the detection of signs of pain and nociception by the medical staff is therefore essential for the wellbeing and management of these patients. However, there is still a lot unknown and a lack of clear guidelines regarding the assessment, management and treatment of pain and nociception in these populations. The purpose of this narrative review is to examine the current knowledge regarding this issue by covering different topics such as: the neurophysiology of pain and nociception (in healthy subjects and patients), the source and impact of nociception and pain in DoC and LIS and, finally, the assessment and treatment of pain and nociception in these populations. In this review we will also give possible research directions that could help to improve the management of this specific population of severely brain damaged patients. Frontiers Media S.A. 2023-03-20 /pmc/articles/PMC10067681/ /pubmed/37021037 http://dx.doi.org/10.3389/fnsys.2023.1112206 Text en Copyright © 2023 Bonin, Lejeune, Szymkowicz, Bonhomme, Martial, Gosseries, Laureys and Thibaut. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
Bonin, Estelle A. C.
Lejeune, Nicolas
Szymkowicz, Emilie
Bonhomme, Vincent
Martial, Charlotte
Gosseries, Olivia
Laureys, Steven
Thibaut, Aurore
Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review
title Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review
title_full Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review
title_fullStr Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review
title_full_unstemmed Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review
title_short Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review
title_sort assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: a narrative review
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10067681/
https://www.ncbi.nlm.nih.gov/pubmed/37021037
http://dx.doi.org/10.3389/fnsys.2023.1112206
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