Electrophysiological Assessment of Conscious Level
Consciousness and vigilance shift continuously and their behavioral and clinical manifestations are implemented somewhat gradually, each shift corresponding to a different level of activity: waking, various degrees of attentiveness, light, deep and paradoxical sleep, various levels of coma and of altered states of responsiveness, etc. Each of these states is associated with a certain working mode in the brain—though on account of our limited semiologic methods we are not always able to detect each of them or assess it accurately. In comatose states, apart from the clinical data emerging from neurological examination, electrophysiologic techniques such as electroencephalogram (EEG) and evoked potentials (EPs) remain the best possible sources of objective information concerning the functional level of cerebral activity. Essentially the EEG represents the only biological activity suitable for continuous noninvasive monitoring of brain function. This property is especially instrumental in the acute phase of posttraumatic coma where the most important task is to keep the patient’s course under strict control in order to obtain earlier detection of CNS functioning deterioration.
KeywordsFunctional Level Objective Information Strict Control Altered State Paradoxical Sleep
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