Toward a common clinical lexicon of consciousness

Clear, consistent, and universally understood communication is essential to safe and effective medical practice. The use of language for which all parties have a common definition and understanding is a necessary component of this communication. Terminology used in the assessment and management of disturbances in consciousness can at times be variable and imprecise. For example, terms including ‘obtunded’ and ‘stupor’ may have different meanings for individual clinicians. While the neurobiological substrate required for the generation of consciousness is incompletely understood, it is crucial that clinical evaluations of disturbances of consciousness are accurate and reproducible [1]. While there is increasing utility of investigations such as electroencephalogram and functional magnetic resonance imaging (MRI) in the evaluation of consciousness [2], clinical evaluation remains fundamental. Since new disturbances of consciousness can herald a number of life-threatening conditions, clear communication regarding clinical examination findings in these settings is vital.