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Neurology 2003;61:543-545
© 2003 American Academy of Neurology
Brief Communications

Quantification of lethargy in the neuro-ICU

The 60-Second Test

S. A. Mayer, MD, L. J. Dennis, MD, S. Peery, MA, B.-F. Fitsimmons, MD, Y. E. Du, PhD, G. L. Bernardini, MD PhD, C. Commichau, MD and M. Eldaief, MD

From the Division of Critical Care Neurology (Drs. Mayer, Dennis, Fitzsimmons, Bernardini, Commichau, and Eldaief, S. Peery), Department of Neurology, and Department of Neurosurgery (Dr. Mayer), College of Physicians and Surgeons, and Division of Biostatistics (Dr. Du), School of Public Health, Columbia University, New York, NY.

Address correspondence and reprint requests to Dr. S.A. Mayer, Division of Critical Care Neurology, Columbia Presbyterian Medical Center, 710 W. 168 St., Box 39, New York, NY 10032; e-mail: sam14{at}columbia.edu

The authors evaluated the 60-Second Test (SST), a brief test of mental concentration, as a supplement to the Glasgow Coma Scale (GCS) for monitoring verbally responsive patients in the neuro-intensive care unit. The SST demonstrated excellent reliability and was abnormal in 79% of patients assigned a top GCS score of 15. However, both tests had poor responsiveness to clinically identified changes in level of consciousness (LOC). The SST is sensitive to subtle alterations in LOC but, like the GCS, may have limitations as a monitoring tool in the neurocritical care setting.






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