The neurophysiological evaluation of consciousness in the vegetative or comatose patient

Medical, ethical, legal, and economic reasons justify the assessment of possible conscious remnants in comatose and vegetative patients. The A. raises the issue as to whether it is possible to bypass communication and examine consciousness thanks to the recording of scalp electrical brain activities (electroencephalogram, evoked potentials), which can only be achieved on the basis of an operational model of consciousness. The A. chose the recent model of Damasio. According to this model, he suggests that clinical neurophysiology may help delineate two subpopulations of comatose and vegetative patients in whom the presence of some consciousness of the present time can be either virtually ruled out or hypothesized with a high degree of certainty. By contrast, the A. underlines the current limitations of clinical neurophysiology in assessing possible autobiographical consciousness remnants.