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DISORDERS OF CONSCIOUSNESS (DoCs)

Join me for another #neuropalliative care Tweetorial about a very broad and complicated topic: @MedTweetorials #NeuroTwitter #NeuroPal #hapc #MedEd
My goal for this 🧵 is to define key features of coma, vegetative state (VS), and minimally conscious state (MCS). And why it matters for #PalliativeCare.
This is not a Tweetorial on brain death or prognostication right after brain injury. Stay tuned for those🤓 2/17
To understand differences between disorders of consciousness (DoC) is to separate the ideas of being awake and being aware:
3/17 Image
Read 18 tweets
🤤 DROOLING MANAGEMENT 🤤
Join me for my first #neuropalliative care Tweetorial:
1/11
But first, an anatomy refresher:

3 major glands involved: parotid, submandibular (SM), sublingual (SL)

💦 Unstimulated state: about 70% of saliva from SM + SL
💦 Stimulated state: 5x ⬆️ production, mostly via parotid

⚡CN 7 innervates SM & SL
⚡CN 9 innervates parotid

2/11
Saliva is produced via parasympathetic (muscarinic cholinergic) tone and cleared via swallowing.

Drooling = when thin saliva is present past the lip margin

Etiologies:
1. Impaired clearance (think neuromuscular dz ⬇️ swallowing)
2. Overproduction (think 💊 side effect)

3/11
Read 13 tweets

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