Journal
FRONTIERS IN SYSTEMS NEUROSCIENCE
Volume 17, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fnsys.2023.1112206
Keywords
pain; nociception; disorders of consciousness; locked-in syndrome; pain assessment; pain management; theories of pain
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The assessment and management of pain and nociception in patients unable to communicate functionally is a challenge. There is a lack of clear guidelines for the assessment, management, and treatment of pain in these populations. This review aims to examine the current knowledge and suggest research directions to improve the management of severely brain damaged patients.
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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