Plum and Posner's Diagnosis of Stupor and Coma (Contemporary Neurology Series, 71)

Delirium, stupor and coma are common clinical states that confront clinicians in almost every medical specialty. With appropriate diagnosis and treatment, coma can often be treated successfully. Conversely, delay in diagnosis and treatment may be lethal. This monograph provides an update on the clinical approach that was laid out in the previous 3 editions. It describes an approach for the physician at the bedside to diagnose and treat alterations of consciousness, based on pathophysiologic principles. The book begins with a description of the physiology of consciousness and the pathophysiology of disorders of consciousness. It continues with a description of the approach to a patient with a disorder of consciousness, emphasizing the bedside examination, but including the use of modern imaging techniques. The important structural and metabolic causes of coma are reviewed in detail. It then describes the emergency treatment, both medical and surgical, of patients with specific disorders of consciousness and their prognosis. New chapters describe the approach to the diagnosis of brain death and the clinical physiology of the vegetative state and minimally conscious state, as well as the ethics of dealing with such patients and their families. The book is aimed at medical students and residents, in fields from internal medicine and pediatrics to emergency medicine, surgery, neurology, neurosurgery, and psychiatry, who are likely to encounter patients with disordered states of consciousness. It includes historical background and basic neurophysiology that is important for those in the clinical neurosciences, but also lays out a practical approach to the comatose patient that is an important part of the repertoire of all clinicians who provide emergency care for patients with disorders of consciousness. Doody Review Services Reviewer: Bradley J. Robottom, MD(University of Maryland School of Medicine) Description: This is a welcome update of a classic neurology text last revised in 1982 that focuses on the pathophysiology, etiology, and diagnosis of altered states of consciousness. Purpose: The book offers a straightforward approach to the diagnosis and management of comatose patients. Despite the widespread availability of imaging modalities such as CT scan and MRI, the examination of the comatose patient remains the cornerstone of diagnosis and treatment. The book instructs readers how to evaluate the comatose patient in a comprehensive and timely fashion, allowing for prompt diagnosis and treatment. Audience: Although written for neurologists, both residents in training and practicing physicians, those in other specialties, particularly those which deal with the emergent care of critically ill patients, would benefit from this book. The authors are recognized experts in the field, with the most senior authors, Plum and Posner, having written the first three editions. Features: The book systematically addresses the pathophysiology underlying coma, the examination and diagnostic evaluation of the comatose patient, and the etiology and prognosis of coma. One chapter in particular, on the examination of the comatose patient, should be considered required reading for anyone completing a neurology residency. The authors' coverage of this topic is timeless and has changed little from earlier editions. One welcome feature of this edition is the presence of detailed, high quality images including MRI, SPECT imaging, CT perfusion scanning, and more. Assessment: This is an excellent text, and the substantial changes since the third edition easily justify the purchase of a new copy. Delirium, stupor and coma are common clinical states that confront clinicians in almost every medical specialty. With appropriate diagnosis and treatment, coma can often be treated successfully. Conversely, delay in diagnosis and treatment may be lethal. This monograph provides an update on the clinical approach that was laid out in the previous 3 editions. It describes an approach for the physician at the bedside to diagnose and treat alterations of consciousness, based on pathophysiologic principles. The book begins with a description of the physiology of consciousness and the pathophysiology of disorders of consciousness. It continues with a description of the approach to a patient with a disorder of consciousness, emphasizing the bedside examination, but including the use of modern imaging techniques. The important structural and metabolic causes of coma are reviewed in detail. It then describes the emergency treatment, both medical and surgical, of patients with specific disorders of consciousness and their prognosis. New chapters describe the approach to the diagnosis of brain death and the clinical physiology of the vegetative state and minimally conscious state, as well as the ethics of dealing with such patients and their families. The book is aimed at medical students and residents, in fields from internal medicine and pediatrics to emergency medicine, surgery, neurology, neurosurgery, and psychiatry, who are likely to encounter patients with disordered states of consciousness. It includes historical background and basic neurophysiology that is important for those in the clinical neurosciences, but also lays out a practical approach to the comatose patient that is an important part of the repertoire of all clinicians who provide emergency care for patients with disorders of consciousness. Provides an update on the clinical approath that was laid out in the previous three editions. It describes an approach for the physician at the bedside to diagnose and treat alterations of consciousness, based on pathophysiologic principles. It beins with a description of the physiology of consicousness and the pathophysiology of disorders of consciousness. It contnues with a description of the approach to a patient with a disorder of consiousness, emphasizing the bedside examination, but including the use of modern imaging techniques. The important structural and metabolic causes of coma are reviewed in detail. It then describes the emergency treatment, both medical and surgical, of patients with specific disorders of consciousness and their prognosis. New chapters describe the approach to the diagnosisof brain death and the clinical physiology of the vegetative state and minimally consiouls state, as well as the ethics of dealing with such patients and their families This volume describes the clinical approach to patients with abnormal states of consciousness including delirium, stupor and coma. It describes the pathophysiology, clinical and imaging findings, treatment and prognosis of such patients