Neurology Edited by Professor Emeritus Desire' Dubounet, IMUNE

some supervision and/or direction3. There is a degree of impairment of complex integrated cerebral function that limits dailyactivities to directed care under of confinement at home or in other domicile4. There is such a severe degree of impairment of complex integrated cerebral functionsthat the individual is unable to care for self in any situation or mannerEmotional disturbancesEmotional disturbances may be one of the results of organic brain damage. Thesedisturbances may range from irritability to outbursts of severe rage and aggression, or at theother extreme, to an absence of normal emotional response. The abnormalities includeinappropriate euphoria, depression, degrees of fluctuation of emotional state, impairment ofnormal emotional interactions with others, involuntary laughing and crying, akinetic mutism,and other disturbances in the emotional sphere. The criteria for evaluating such disturbancesare:Description% Impairmentof the Whole Person1. There is mild to moderate emotionaldisturbance under unusual stress 5-15There is mild to moderate emotionalDisturbance under ordinary stress 20-45There is moderate to severe emotionalDisturbance under ordinary to minimalStress, which requires sheltering 50-90There is severe emotional disturbanceThat continually endangers self or others 95Consciousness DisturbancesDisturbances of consciousness that are not covered in the episodic disorders or in the sleepand arousal disorders, which are described below, include organic confusional state (hyperor hypoactive), stupor (poorly organized responses to noxious stimuli), and coma (noresponse).Determination of grades of impairment of consciousness may be made by judging thepatient’s reaction to noxious stimuli; this may vary from a well-organized reaction to none atall.Description% Impairmentof thewhole person1. Neurological disorder results in mildAlteration in the state of consciousness 5-35