brain, spinal cord, and nerve disorders
Minimally Conscious State
Treatment of Minimally Conscious State
Preventive measures for problems due to immobilization Good nutrition Possibly certain drugs Like people in a Stupor and Coma , people in a minimally conscious state require comprehensive care. Providing good nutrition ( Overview of Nutritional Support ) is important. People are fed through a tube inserted through the nose and into the stomach (called tube feeding). Sometimes they are fed through a tube inserted directly into the stomach or small intestine through an incision in the abdomen. Drugs may also be given through these tubes. Many Problems Due to Bed Rest result from being unable to move, and measures to prevent them are essential. For example, the following can happen: Pressure Sores : Contractures:Lack of movement can also lead to permanent stiffening of muscles (contractures) causing joints to become permanently bent. Lack of movement makes blood clots more likely to form in leg veins—called Deep Vein Thrombosis (DVT) . Damage to muscles and nerves in the arms and legs:Lack of movement or lying in one position for a long time can put pressure on a nerve that runs close to the surface of the body near a prominent bone, such as a nerve in an elbow, a shoulder, a wrist, or a knee. Such pressure can injure the nerve. As a result, the muscles that the nerve controls function less well. Pressure sores can be prevented by frequently repositioning the person and placing protective padding under parts of the body that are in contact with the bed, such as the heels, to protect them. To prevent contractures, physical therapists gently move the person’s joints in all directions (passive range-of-motion exercises) or splint joints in certain positions. Preventing blood clots includes use of drugs and compression or elevation of the person's legs. Moving the limbs, as occurs in passive-range-of-motion exercises, may also help prevent blood clots. If people are incontinent, care should be taken to keep the skin clean and dry. If the bladder is not functioning and urine is being retained, a tube (catheter) may be placed in the bladder to drain urine. Catheters are carefully cleaned and regularly examined to prevent urinary tract infections from developing. A very few people have improved after certain drugs were prescribed, but only for as long as the drug was continued. These drugs includezolpidem(a sleep aid),apomorphine(used to treat Parkinson disease), andamantadine(used to treat viral infections). However, no treatment has been proved effective in the long term. Music therapy may have some slight beneficial effects by stimulating some response in people in a minimally conscious state. But the usefulness of this therapy is as yet unclear. 