Terme de Glossaire

The question of pain is an essential one for patients in a minimally conscious state or for LIS patients, as it is known that they are faced with it. But when and according to what posology? Not only can these patients not say that they are in pain, but they are also incapable of signalling that they are no longer experiencing pain (whilst difficult, a form of communication is possible in LIS patients after a correct diagnosis of their condition). To get round this stumbling block the Coma Science Group team has developed a scale called the Nociception Coma Scale (1), inspired by the scales used on newborns and permanently bedridden dementia patients.

The Nociception Coma Scale, developed by Caroline Schnakers, allows the evaluation of pain to be standardised. It is graduated from 0 to 12. If the score obtained is 7 or higher at the end of tests which evaluate motor, visual and vocal responses as well as facial expressions, treatment must be administered. At first not very powerful analgesics will be given. The treatment will be progressively intensified until the patient’s score, re-evaluated, remains below 7.

(1) Schnakers C, Chatelle C, Vanhaudenhuyse A, Majerus S, Ledoux D, Boly M, Bruno MA, Boveroux P, Demertzi A, Moonen G, Laureys S, The Nociception Coma Scale : A new tool to assess nociception in disorders of consciousness, Pain 148 (2010) 215-9.