Prolonged disorder of consciousness: giving a second opinion on the best interests of a person.

Patients with a prolonged disorder of consciousness have a neurological disorder. Few neurologists undertake assessment and management after the acute phase of the person's illness, even though some of their patients with progressive neurological disorders become persistently unconscious. Their clinical evaluation and deciding on their best interests require full use of a neurologist's expertise, which is intellectually, emotionally and clinically challenging. I will cover essential aspects of giving such an expert second opinion based on at least 200 cases where I have done so (and over 500 patients seen clinically).