Introduction: Resistance to eye opening (REO) is a commonly encountered phenomenon in clinical practice. We aim to investigate whether REO is a sign of consciousness or a reflex in severely brain-injured patients. Methods: We recorded REO in chronic patients with disorders of consciousness during a multimodal diagnostic assessment. REO evaluations were performed daily in each patient and clinical diagnosis of unresponsive wakefulness syndrome (UWS), minimally conscious state with (MCS+) or without (MCS−) preserved language processing was made using the Coma Recovery Scale-Revised (CRS-R). Results: Out of 150 consecutive patients, 79 patients fit inclusion criteria. REO was seen in 19 patients (24.1%). At the group level, there was a significant relationship between the presence of REO and the level of consciousness. We also observed a difference in the repeatability of REO between patients in UWS, MCS− and MCS+. Out of 23 patients in UWS, six showed REO, in whom five showed atypical brain patterns activation. Conclusion: Our findings suggest a voluntary basis for REO and stress the need for multiple serial assessments of REO in these patients, especially since most patients show fluctuating levels of consciousness.
CITATION STYLE
van Ommen, H. J., Thibaut, A., Vanhaudenhuyse, A., Heine, L., Charland-Verville, V., Wannez, S., … Gosseries, O. (2018). Resistance to eye opening in patients with disorders of consciousness. Journal of Neurology, 265(6), 1376–1380. https://doi.org/10.1007/s00415-018-8849-0
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