Discussion
This case-report demonstrates the challenges and the opportunities that
clinicians face when they are called to assess consciousness in patients
in whom brain injury results in inconsistent responsiveness and motor
behavior. The trajectory we describe here clearly highlights the problem
of discriminating between unconsciousness and unresponsiveness and shows
how a comprehensive hierarchical assessment, combining clinical and
advanced paraclinical markers, can help minimizing diagnostic error. At
the same time, the comprehensive multimodal exploration performed here
prompts an interesting pathophysiological reflection on the
relationships between DoC, AM and extreme parkinsonism.