Article

Previous findings suggest that language disorders may occur in
severely brain-injured patients and could interfere with behavioral assessments
of consciousness. However, no study investigated to what extent language
impairment could affect patients' behavioral responses.
Objective. To estimate
the impact of receptive and/or productive language impairments on consciousness
assessment. Methods. Twenty-four acute and subacute stroke patients with
different types of aphasia (global, n = 11; Broca, n = 4; Wernicke, n = 3;
anomic, n = 4; mixed, n = 2) were recruited in neurology and neurosurgery units
as well as in rehabilitation centers. The Coma Recovery Scale-Revised (CRS-R) was
administered. Results. We observed that 25% (6 out of 24) of stroke patients with
a diagnosis of aphasia and 54% (6 out of 11) of patients with a diagnosis of
global aphasia did not reach the maximal CRS-R total score of 23. An
underestimation of the consciousness level was observed in 3 patients with global
aphasia who could have been misdiagnosed as being in a minimally conscious state,
even in the absence of any documented period of coma. More precisely, lower
subscores were observed on the communication, motor, oromotor, and arousal
subscales. Conclusion. Consciousness assessment may be complicated by the
co-occurrence of severe language deficits. This stresses the importance of
developing new tools or identifying items in existing scales, which may allow the
detection of language impairment in severely brain-injured patients.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS