eanCast: Weekly Neurology14 Des 2025

Ep. 179: Language and communication impairment after coma

Moderator: Alfonso Magliacano (Florence, Italy) Guest: Charlène Aubinet (Liege, Belgium) In this episode, Alfonso Magliacano is joined by Charlène Aubinet to examine how language and communication impairments shape the assessment and recovery of patients emerging from coma. They discuss the clinical distinctions between unresponsive wakefulness syndrome and the minimally conscious state, highlighting how aphasia and other comorbidities can obscure signs of awareness and lead to misdiagnosis. Dr. Aubinet outlines emerging tools, from eye-tracking assessments to EEG and fMRI markers, that help detect residual language processing even without behavioral responses. The conversation also explores how early linguistic abilities can serve as prognostic indicators, the practical challenges faced by speech therapists, and the evidence that some language processing may persist even in states of severely impaired consciousness, with important clinical and ethical implications.

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