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| Line 30: |
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| * [[Ddx:Intracranial Bleeding|Subarachnoid hemorrhage]] | | * [[Ddx:Intracranial Bleeding|Subarachnoid hemorrhage]] |
| * [[Ddx:Syncope|Syncopes]] | | * [[Ddx:Syncope|Syncopes]] |
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| |
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| |
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| |
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| |
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| Line 194: |
Line 192: |
| * [[Alicyclic hydrocarbons poisoning]] | | * [[Alicyclic hydrocarbons poisoning]] |
| * [[Allethrin poisoning]] | | * [[Allethrin poisoning]] |
| * [[Acute altitude sickness]] | | * Acute [[altitude sickness]] |
| * [[Alzheimer's disease]] | | * [[Alzheimer's disease]] |
| * [[Amanita polypyramis poisoning]] | | * [[Amanita polypyramis poisoning]] |
| Line 211: |
Line 209: |
| * [[Anchovy (clupeotoxin) poisoning]] | | * [[Anchovy (clupeotoxin) poisoning]] |
| * [[Aniline poisoning]] | | * [[Aniline poisoning]] |
| * [Anoxemia]] | | * [[Anoxemia]] |
| * [[Anticholinergic syndrome]] | | * [[Anticholinergic syndrome]] |
| * [[Antifreeze poisoning]] | | * [[Antifreeze poisoning]] |
| Line 273: |
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| * [[Carbon Tetrachloride]] | | * [[Carbon Tetrachloride]] |
| * [[Carbophenothion]] | | * [[Carbophenothion]] |
| * [[Carcinomatosis meningitis]] | | * [[Carcinomatosis]] [[meningitis]] |
| * [[Cardiac arrest]] | | * [[Cardiac arrest]] |
| * [[Carnitine deficiency (systemic)]] | | * [[Carnitine deficiency (systemic)]] |
| Line 336: |
Line 334: |
| * [[Daphne poisoning]] | | * [[Daphne poisoning]] |
| * [[Darvocet]] | | * [[Darvocet]] |
| * [[Ddx:Hyperthermia|Hyperthermia | | * [[Ddx:Hyperthermia|Hyperthermia]] |
| * [[Ddx:Hypocalcemia|Hypocalcemia]] | | * [[Ddx:Hypocalcemia|Hypocalcemia]] |
| * [[Ddx:Hypoglycemia|Hypoglycemia]] | | * [[Ddx:Hypoglycemia|Hypoglycemia]] |
| Line 385: |
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| * [[Encephalitis]] | | * [[Encephalitis]] |
| * [[Encephalomyelitis]] | | * [[Encephalomyelitis]] |
| * [[End Stage Liver Failure]] | | * End Stage [[Liver Failure]] |
| * [[Endocarditis]] | | * [[Endocarditis]] |
| * [[Endothion poisoning]] | | * [[Endothion poisoning]] |
| Line 447: |
Line 445: |
| * [[Hemiplegic migraine, familial type 1]] | | * [[Hemiplegic migraine, familial type 1]] |
| * [[Hemolytic uremic syndrome]] | | * [[Hemolytic uremic syndrome]] |
| * [[Hemorrhagic shock and encephalopathy syndrome]] | | * [[Hemorrhagic shock]] and [[encephalopathy]] syndrome |
| * [[Hendra Virus]] | | * [[Hendra Virus]] |
| * [[Hepatic encephalopathy syndrome]] | | * [[Hepatic encephalopathy]] syndrome |
| * [[Hepatitis]] | | * [[Hepatitis]] |
| * [[Heptenophos poisoning]] | | * [[Heptenophos poisoning]] |
| Line 484: |
Line 482: |
| * [[Hypothermia]] | | * [[Hypothermia]] |
| * [[Hypothyroidism]] | | * [[Hypothyroidism]] |
| * [[Hypoxic encepahalopathy]] | | * [[Hypoxic encephalopathy]] |
| * [[Hysteria]] | | * [[Hysteria]] |
| * [[Ibuprofen]] | | * [[Ibuprofen]] |
| Line 534: |
Line 532: |
| * [[Meningoencephalitis]] | | * [[Meningoencephalitis]] |
| * [[Mephenoxalone]] | | * [[Mephenoxalone]] |
| * [[Mepiridine]] | | * [[Meperidine]] |
| * [[Meprobamate]] | | * [[Meprobamate]] |
| * [[Mercury]] | | * [[Mercury]] |
| Line 552: |
Line 550: |
| * [[Methyldopa]] | | * [[Methyldopa]] |
| * [[Methylmalonic acidemia]] | | * [[Methylmalonic acidemia]] |
| * [[Methylmalonicaciduria with homocystinuria, cobalamin F]] | | * [[Methylmalonic aciduria]] with [[homocystinuria]], [[cobalamin F]] |
| * [[Methylmalonicaciduria, vitamin B12 unresponsive]] | | * [[Methylmalonic aciduria]], vitamin B12 unresponsive |
| * [[Methyprylon]] | | * [[Methyprylon]] |
| * [[Metoclopramide]] | | * [[Metoclopramide]] |
| Line 609: |
Line 607: |
| * [[Phenobarbital]] | | * [[Phenobarbital]] |
| * [[Phenothiazine poisoning]] | | * [[Phenothiazine poisoning]] |
| * [[Pheochromocytoma crisis]] | | * [[Pheochromocytoma]] crisis |
| * [[Phorate poisoning]] | | * [[Phorate poisoning]] |
| * [[Phosalone poisoning]] | | * [[Phosalone poisoning]] |
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| * [[Spinal cord injury, acute]] | | * [[Spinal cord injury, acute]] |
| * [[Streptococcal Group B invasive disease]] | | * [[Streptococcal Group B invasive disease]] |
| * [[Streptococcal Toxic Shock Syndrome]] | | * [[Streptococcal toxic shock syndrome]] |
| * [[Stroke]] | | * [[Stroke]] |
| * [[Styrene]] | | * [[Styrene]] |
| Line 700: |
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| * [[Tetramethrin poisoning]] | | * [[Tetramethrin poisoning]] |
| * [[Tetramethylenedisulfotetramine poisoning]] | | * [[Tetramethylenedisulfotetramine poisoning]] |
| * [[Thallium Sulfate]] | | * [[Thallium sulfate]] |
| * [[Thiamine (Vitamin B1) deficiency]] | | * [[Thiamine (Vitamin B1) deficiency]] |
| * [[Thiometon]] | | * [[Thiometon]] |
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| * [[Trifenfos]] | | * [[Trifenfos]] |
| * [[Trifluperidol]] | | * [[Trifluperidol]] |
| * [[Trimethropin]] | | * [[Trimethoprim]] |
| * [[Typhoid fever]] | | * [[Typhoid fever]] |
| * [[Uranium]] | | * [[Uranium]] |
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| * [[Venezuelan equine encephalitis]] | | * [[Venezuelan equine encephalitis]] |
| * [[Snakebite]] | | * [[Snakebite]] |
| * [[Spider bites]] | | * [[Spider bite]] |
| * [[Ventricular fibrillation]] | | * [[Ventricular fibrillation]] |
| * [[Very low blood pressure]] | | * [[Very low blood pressure]] |
| * [[Vicodin]] | | * [[Vicodin]] |
| * [[Vigabatrin]] | | * [[Vigabatrin]] |
| * [[Viral Hemorrhagic Fevers]] | | * [[Viral Hemorrhagic fevers]] |
| * [[Waterhouse-Friderichsen syndrome]] | | * [[Waterhouse-Friderichsen syndrome]] |
| * [[Wernicke-Korsakoff syndrome]] | | * [[Wernicke-Korsakoff syndrome]] |
| Line 752: |
Line 750: |
| * [[Wild Lima bean poisoning]] | | * [[Wild Lima bean poisoning]] |
| * [[Xanax overdose]] | | * [[Xanax overdose]] |
| * [[X-linked adrenoleukodystrophy]] -- Addison disease | | * [[X-linked adrenoleukodystrophy -- Addison disease only |
| * [[Yellow fever]] | | * [[Yellow fever]] |
| * [[Zaleplon]] | | * [[Zaleplon]] |
For patient information click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
In medicine, a coma (from the Greek Template:Polytonic koma, meaning deep sleep) is a profound state of unconsciousness. A comatose patient cannot be awakened, fails to respond normally to pain or light, does not have sleep-wake cycles, and does not take voluntary actions. Coma may result from a variety of conditions, including intoxication, metabolic abnormalities, central nervous system diseases, acute neurologic injuries such as stroke, and hypoxia. It may also be deliberately induced by pharmaceutical agents in order to preserve higher brain function following another form of brain trauma, or to save the patient from extreme pain during healing of injuries or diseases. A coma may also result from immense head trauma caused by something like a car accident or a series of very severe concussions. The underlying cause of the coma is bilateral damage to the Reticular formation of the midbrain, which is important in regulating sleep [1].
Differential Diagnosis of Causes of Coma
(Most common causes)
By organ system
| Cardiovascular
|
Heart attack, Heart failure, Malignant hypertension, Shock, Ventricular fibrillation, Very low blood pressure, Cardiac dysrhythmias, Endocarditis, Rheumatic Fever
|
| Chemical / poisoning
|
1,1-Dimethylhydrazine poisoning, 2-Methyl-4-Chlorophenoxyacetic Acid poisoning , Acetone poisoning, Acetylene poisoning , Ackee Fruit Food poisoning , Acrolein poisoning, Acute Chemical poisoning -- Varnish makers' and painters' Naptha, Acute xylene poisoning, Aftershave poisoning, Alcohol intoxication, Aldrin poisoning, Alicyclic hydrocarbons poisoning, Allethrin poisoning, Amanita polypyramis poisoning, Amidithion poisoning, Amiton poisoning, Ammonium Bifluoride, Ammonium Sulfamate poisoning, Anchovy (clupeotoxin) poisoning , Aniline poisoning, Antifreeze poisoning, Apricot seed poisoning, Azinfos-methyl poisoning, Azinphos-ethyl poisoning, Azinphosmetile poisoning, Azothoate poisoning, Benoxafos poisoning, Bentazon poisoning, Benzene toxicity, Beta ketothiolase deficiency, Bird cherry seed poisoning, Bitter almond seed poisoning, Black henbane poisoning, Black jetbead poisoning, Blue-ringed octopus poisoning, Boric Acid, Box Jellyfish poisoning, Bromide toxicity, Bromoform poisoning, Butyl Alcohol poisoning, Camphor, Cannabinoids, Carbamate insecticide poisoning, Carbaryl, Carbinoxamine, Carbon monoxide poisoning, Carbon Tetrachloride, Carbophenothion, Celandine poisoning, Cherry laurel seed poisoning, Cherry seed poisoning, Chlophedianol toxicity, Chloral hydrate poisoning, Chlorate salts poisoning, Chlorfenvinphos poisoning, Chloromethane poisoning, Chloropyrifos poisoning, Chlorpyrifos poisoning, Chokecherry seed poisoning, Christmas Cherry poisoning, Chromium poisoning, Clupeotoxism, Cobra poisoning, Cocaine, Common poppy poisoning, Cone shell poisoning, Copper toxicity, Coumaphos poisoning, Cresols poisoning, Cresylic acid poisoning, Cyanide poisoning, Daphne poisoning, Darvocet overdose, Death Angel poisoning, Death Camas poisoning, Demethyldiazepam toxicity, Demeton-O-methyl poisoning, Demeton-S-methyl poisoning, Demeton-S-methylsulphon poisoning, Devil's trumpet poisoning, Dialifos poisoning, Diazinon poisoning, Dichloralphenazone poisoning, Dichloronaphthoquinone poisoning, Dichlorvos poisoning, Dicrotophos poisoning, Dieldrin poisoning, Diethylene Glycol poisoning, Dimethoate poisoning, Dimethyl Phthalate poisoning, Dinitrocresol poisoning, Dinitrophenol poisoning, Di-n-Octyl phathalate poisoning, Dioxathion poisoning, Disulfoton poisoning, Endothion poisoning, English Ivy poisoning, English Laurel poisoning, Ethchlorvynol poisoning, Ethion poisoning, Ethoate-methyl poisoning, Ethoprophos poisoning, Ethylene Glycol poisoning, Ethyl-guthion poisoning, Etrimfos poisoning, Eucalyptus Oil poisoning, Fenchlorphos poisoning, Fenitrothion, Fensulfothion, Fenthion poisoning, Fire cherry poisoning, Fonophos poisoning, Formaldehyde poisoning, Formothion poisoning, Funnel Web spider poisoning, Hair Bleach, Hair Dye, Heptenophos poisoning, Hexachlorobutadiene poisoning, Hyacinth bean poisoning, Imazapyr poisoning, Iodofenphos poisoning, Japanese pagoda tree poisoning, Jessamine poisoning, Jimsonweed poisoning, 1,2-Dichloromethane, Amyl Alcohol, Aristolochic acid, Arsenic, Cadmium, Degreasing solvents, Dichloroacetylene, Diethylene glycol, Ethylene glycol ethers, Gasoline, Germanium, Glue solvent vapors, Heavy metals, Herbicide, Hexachloro-1,3-butadiene, Hydrocarbons, Lead, Mercury, Methanol, Methemoglobin-producing agents, Paint thinners, Paints, Paraquat ochratoxin A, Perchloroethylene, Platinum, Silicon compounds, Silver, Solvents, Styrene, Thallium, Toluene, Trichloroethane, Trichloroethylene, Uranium, Lantana poisoning, Lead poisoning, Lobelia poisoning, Loquat poisoning, Lupine poisoning, Mayapple poisoning, Mecarbam, Mephenoxalone, Metaldehyde, Methacrifos, Methamidophos, Methaqualone, Methidathion, Methyl Bromide, Methyprylon, Mexican tea poisoning, Nabilone, Naked brimcap poisoning, Omethoate poisoning, Organophosphate insecticide poisoning, Oxydeprofos poisoning, Oxydisulfoton poisoning, Parathion poisoning, Pentachlorophenol poisoning, Phorate poisoning, Phosalone poisoning, Phosdrin poisoning, Phosmet poisoning, Phosphamidon poisoning, Phoxim poisoning, Phthalthrin poisoning, Pirimiphos-methyl, Poison hemlock poisoning, Polyethylene Glycol -- Low Molecular Weight, Primiphos methyl, Profenofos, Propoxur, Prothidathion poisoning, Prothoate poisoning, Pyrimidifen poisoning, Pyrimitate poisoning, Quinalphos poisoning, Quintiofos poisoning, Ramelteon poisoning, Sardine poisoning (clupeotoxin), Selenious Acid, Slickhead poisoning (clupeotoxin), Sodium Monofluoroacetate, Sophamide, Sulfotep poisoning, Systemic monochloroacetate poisoning, Tapioca poisoning, Terbufos poisoning, Tetraethyl Pyrophosphate poisoning, Tetrahydrocannabinol, Tetramethrin poisoning, Tetramethylenedisulfotetramine poisoning, Thallium sulfate, Thiometon, Thornapple poisoning, Tolclofos methyl poisoning, Toluene, Triazophos poisoning, Triazotion poisoning, Trichloroethane, Triclofos, Triethylene Glycol, Trifenfos, White snakeroot poisoning, Wild cherry seed poisoning, Wild Lima bean poisoning
|
| Dermatologic
|
No underlying causes
|
| Drug Side Effect
|
No underlying causes
|
| Ear Nose Throat
|
No underlying causes
|
| Endocrine
|
ACTH resistance, Addison's Disease, Diabetic coma, Diabetic ketoacidosis, Functioning pancreatic endocrine tumor, Hyperosmolar non-ketotic diabetic coma, Hyperparathyroidism, Hypoglycemia, Hypothyroidism, Insulinoma, Metastatic insulinoma, Multiple endocrine neoplasia type 1, Multiple endocrine neoplasia type 2, Multiple endocrine neoplasia type 3, Thyroid gland failure, X-linked adrenoleukodystrophy -- Addison disease only, Pituitary apoplexy, Congenital Hyperinsulinism, Hyperinsulinism due to glucokinase deficiency, Hyperinsulinism due to glutamodehydrogenase deficiency, Pheochromocytoma crisis
|
| Environmental
|
Altitude sickness, Comly syndrome, Dehydration, Heat stroke, Hyperbaric sickness, Hypothermia, Mountain sickness, Near-drowning, Suffocation, High altitude cerebral edema
|
| Gastroenterologic
|
End Stage Liver Failure, Hepatitis, Progressive familial intrahepatic Cholestasis 2, progressive familial intrahepatic Cholestasis 3, Hepatic encephalopathy
|
| Genetic
|
2-methylbutyryl-coenzyme A dehydrogenase deficiency, 3 alpha methylcrotonyl-Coa carboxylase 1 deficiency, 3 alpha methylcrotonyl-coa carboxylase 2 deficiency, 3-methylcrotonyl-CoA carboxylase deficiency, Arginosuccinic aciduria, Carbamoyl-phosphate synthase 1 deficiency, Carnitine deficiency (systemic), Carnitine transporter deficiency, Citrullinemia I, Citrullinemia II, Congenital Hyperinsulinism, Flavoprotein deficiency, Fructose-1,6-bisphosphatase deficiency, hereditary, Fructose-1-phosphate aldolase deficiency, hereditary, Fumarase deficiency, Glycine synthase deficiency, HMG-CoA lyase deficiency, Holocarboxylase synthetase deficiency, Hyperinsulinism due to glucokinase deficiency, Hyperinsulinism due to glutamodehydrogenase deficiency, Isovaleric Acidemia, Late onset Argininosuccinase lyase deficiency, Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency, Medium-Chain Acyl-CoA Dehydrogenase Deficiency, Neonatal Argininosuccinase lyase deficiency, Ornithine transcarbamylase (OTC) Deficiency, Fatal familial insomnia, Inborn urea cycle disorder, Methylmalonic acidemia, Methylmalonic aciduria with homocystinuria and cobalamin F, Mitochondrial acetoacetyl-CoA thiolase deficiency, N-acetyl glutamate synthetase deficiency
|
| Hematologic
|
Antiphospholipid Syndrome, Hemolytic uremic syndrome, Thrombotic thrombocytopenic purpura, Waterhouse-Friderichsen syndrome
|
| Iatrogenic
|
No underlying causes
|
| Infectious Disease
|
Bacterial:
Ehrlichiosis, Epidemic typhus, Melioidosis, Rocky Mountain spotted fever, Septicemia, Streptococcal Group B invasive disease, Typhoid fever, Vancomycin resistant enterococcal bacteremia, Brain abscess, Cerebellar abscess, Cerebral abscess, Meningitis, Postoperative septicaemia
Virus:
Herpes simplex encephalitis, Meningitis, Arbovirosis, Hendra Virus, HIV/AIDS, Kyasanur-Forrest disease, Lyssavirus, Rabies, Rift Valley Fever, Simian B virus infection, Togaviridae disease, Viral Hemorrhagic Fever, West nile encephalitis, Western equine encephalitis, Yellow fever, HHV-6 encephalitis, Venezuelan equine encephalitis, Western/Eastern/California encephalitis
Fungus:
Cryptococcal Meningitis
Parasites:
Chagas disease, Katayama fever, Malaria, Sleeping sickness (East African), Sleeping sickness (West African), Toxoplasmosis
|
| Musculoskeletal / Ortho
|
No underlying causes
|
| Neurologic
|
Acute Disseminated Encephalomyelitis, ADANE, African Sleeping sickness, Alzheimer's disease, Basedow's coma, Bing-Neel syndrome, Brain abscess, Brain cancer, Brain compression, Brain cyst, Brain death, Bristowe's syndrome, Brown-Symmers disease, Cataplexy, Cerebellar abscess, Cerebral abscess, Cerebral hemorrhage, Cerebral metastases, Concussion, Creutzfeldt-Jakob Disease, Cryptococcal Meningitis, Encephalitis, Encephalomyelitis, Epidural haemorrhage, Epilepsy, Fatal familial insomnia, Hashimoto's encephalitis, Familial type 1 hemiplegic migraine, Hemorrhagic shock and encephalopathy syndrome, Hepatic encephalopathy, HHV-6 encephalitis, High altitude cerebral edema, , Hypoxic encephalopathy, Intracerebral hematoma, Jamaican vomiting sickness, Japanese encephalitis, Marchiafava-Bignami disease, Meningoencephalitis, Narcolepsy, Persistent vegetative state, Pituitary apoplexy, Raised intracranial pressure, Acute Spinal cord injury, Stroke, Subarachnoid hemorrhage, Subdural haemorrhage, Traumatic Brain Injury, Vanishing white matter leukodystrophy, Venezuelan equine encephalitis, Western/Eastern/California encephalitis, Westphal-Leyden ataxia, Chagas disease, Herpes simplex encephalitis, Carcinomatosis meningitis, Catatonia, Hydrocephalus
|
| Nutritional / Metabolic
|
Biotinidase deficiency, Hyperglycerolemia-juvenile form, Hyperornithinemia-hyperammonemia-homocitrullinuria syndrome, Inborn amino acid metabolism disorder, Inborn Urea cycle disorder, Leucinosis, Maple syrup urine disease, Methylmalonic Acidemia, Methylmalonic aciduria with homocystinuria, cobalamin F, Vitamin B12 unresponsive methylmalonicaciduria, Mitochondrial acetoacetyl-CoA thiolase deficiency, Mitochondrial trifunctional protein deficiency, N-acetyl glutamate synthetase deficiency, Periodic hyperlysinemia, Porphyria, Pyruvate carboxylase deficiency, Group B, Thiamine (Vitamin B1) deficiency, Uremia, Wernicke-Korsakoff syndrome, 2-methylbutyryl-coenzyme A dehydrogenase deficiency, 3 alpha methylcrotonyl-Coa carboxylase 1 deficiency, 3 alpha methylcrotonyl-coa carboxylase 2 deficiency, 3-methylcrotonyl-CoA carboxylase deficiency, Arginosuccinic aciduria, Carbamoyl-phosphate synthase 1 deficiency, Carnitine deficiency (systemic), Carnitine transporter deficiency, Citrullinemia I, Citrullinemia II, Flavoprotein deficiency, Fructose-1,6-bisphosphatase deficiency, hereditary, Fructose-1-phosphate aldolase deficiency, hereditary, Fumarase deficiency, Glycine synthase deficiency, HMG-CoA lyase deficiency, Holocarboxylase synthetase deficiency, Isovaleric acidemia, Late onset Argininosuccinase lyase deficiency, Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency, Medium-chain Acyl-CoA dehydrogenase deficiency, Neonatal Argininosuccinase lyase deficiency, Ornithine transcarbamylase (OTC) Deficiency
|
| Obstetric/Gynecologic
|
Eclampsia, Pregnancy toxemia
|
| Oncologic
|
Brain cancer, Cerebral metastases, Functioning pancreatic endocrine tumor, Insulinoma, Metastatic insulinoma
|
| Opthalmologic
|
No underlying causes
|
| Overdose / Toxicity
|
Acetylsalicylic Acid, Amitriptyline, Amlodipine, Antipsychotic drugs, Lorazepam overdose, Atropine, Baclofen, Barbiturates, Benzodiazepine, Bromazepam, Bupivacaine, Buprenorphine, Buspirone, Chlorpheniramine, Chlorpromazine, Cinnarizine, Clonazepam, Clonidine, Clotiapine, Codeine, Colchicine, Tricyclic antidepressant, Cyclobenzaprine, Cycloserine, Dantrolene, Meperidine (patient information), Deserpidine, Desipramine, Diamorphine, Diazepam, Diphenhydramine, Diphenidol, Disulfiram, Dothiepin, Efavirenz, Eszopiclone, Ether, Ethinamate, Felodipine, Flurazepam, Flunitrazepam, Gabapentin, Ganaxolone, General anaesthesia, Glutethimide, Haloperidol, Heroin, Hydroxyzine, Inhalational anaesthetics, Isoniazid, Isradipine, Acetaminophen, Aminoglycosides, Aminosalicylic acid, Amphotericin B, Aspirin, Bacitracin, Bismuth, Cefaloridine, Chloroform, Chlortetracycline, Cisplatin, Contrast agents, Cyclophosphamide, Cyclosporin, Ibuprofen, Lithium, Methicillin, Neomycin, Nonsteroidal anti-inflammatory drugs, Oxytetracycline, Polymyxin, Prostaglandin synthetase inhibitors, Rifampin, Sulphonamides, Trimethoprim, Levetiracetam, Levomepromazine, Lidocaine, Lofexidine, Lorazepam, Malathion, Medazepam, Meprobamate, Methadone, Methamphetamine, Methyldopa, Metoclopramide, Mianserin, Midazolam, Mirtazapine, Morphine, Nimodipine, Nitrates, Nitrazepam, Nitroglycerin, Nitrous oxide, Nortriptyline, Olanzapine, Opioid, Oxazepam, Oxycontin, Perazine, Percocet, Phencyclidine, Phenelzine, Phenobarbital, Phenothiazine, Pipothiazine, Pizotifen, Pramipexole, Prazepam, Pregabalin, Primidone, Prochlorperazine, Propanol, Propiomazine, Propofol, Quetiapine, Quinidine, Reserpine, Temazepam, Thiopentone, Tizanidine, Tolterodine, Topiramate, Tramadol, Triazolam, Trifluperidol, Vicodin, Vigabatrin, Xanax, Dilaudid,
|
| Psychiatric
|
Hysteria
|
| Pulmonary
|
Anoxemia, Asphyxia, Lung disease, Pulmonary embolism, Respiratory acidosis, Respiratory failure
|
| Renal / Electrolyte
|
Acid-Base Imbalance, Chronic kidney disease, End-stage renal disease, Hyperthermia, Hypocalcemia, Hypoglycemia, Hypokalemia, Hypomagnesemia, Hypoosmolality, Hypercalcemia, Hyperkalemia, Hypermagnesemia, Hypernatremia, Hyperosmolality, Hyperphosphatemia, Hypophosphatemia
|
| Rheum / Immune / Allergy
|
Anaphylaxis
|
| Sexual
|
No underlying causes
|
| Trauma
|
Head trauma, Skull fracture
|
| Urologic
|
No underlying causes
|
| Dental
|
No underlying causes
|
| Miscellaneous
|
Alcohol withdrawal syndrome, Amyloidosis, Anticholinergic syndrome, Electrocution, Fat embolism, Graft-versus-host disease, Malignant Buotonneuse fever, Neuroleptic Malignant Syndrome, Oculoleptomeningeal Amyloidosis,postoperative Hemorrhage, Postoperative septicaemia, Reye's syndrome, Self-induced water intoxication and schizophrenic disorders syndrome, Serotoninergic syndrome, Shaken Baby Syndrome, Streptococcal toxic shock syndrome, Ureterosigmoidostomy, Venomous snake bites, Venomous spider bites
|
In alphabetical order
Severity
The severity of coma impairment is categorized into several levels. Patients may or may not progress through these levels. In the first level, the brain responsiveness lessens, normal reflexes are lost, the patient no longer responds to pain and cannot hear.
Contrary to popular belief, a patient in a coma does not always lie still and quiet. They may move, talk, and perform other functions that may sometimes appear to be conscious acts but are not.[2]
Two scales of measurement often used in TBI diagnosis to determine the level of coma are the Glasgow Coma Scale (GCS) and the Ranchos Los Amigos Scale (RLAS). The GCS is a simple 3 to 15-point scale (3 being the worst and 15 being that of a normal person) used by medical professionals to assess severity of neurologic trauma, and establish a prognosis. The RLAS is a more complex scale that has eight separate levels, and is often used in the first few weeks or months of coma while the patient is under closer observation, and when shifts between levels are more frequent.
Outcome
Outcomes range from recovery to death. Comas generally last a few days to a few weeks. They rarely last more than 2 to 5 weeks but some have lasted as long as several years. After this time, some patients gradually come out of the coma, some progress to a vegetative state, and others die. Some patients who have entered a vegetative state go on to regain a degree of awareness. Others remain in a vegetative state for years or even decades (the longest recorded period being 37 years).
[3]
The outcome for coma and vegetative state depends on the cause, location, severity and extent of neurological damage. A deeper coma alone does not necessarily mean a slimmer chance of recovery, because some people in deep coma recover well while others in a so-called milder coma sometimes fail to improve.
People may emerge from a coma with a combination of physical, intellectual and psychological difficulties that need special attention. Recovery usually occurs gradually — patients acquire more and more ability to respond. Some patients never progress beyond very basic responses, but many recover full awareness. Regaining consciousness is not instant: in the first days, patients are only awake for a few minutes, and duration of time awake gradually increases.
Predicted chances of recovery are variable owing to different techniques used to measure the extent of neurological damage. All the predictions are based on statistical rates with some level of chance for recovery present: a person with a low chance of recovery may still awaken. Time is the best general predictor of a chance of recovery: after 4 months of coma caused by brain damage, the chance of partial recovery is less than 15%, and the chance of full recovery is very low. [4][5]
The most common cause of death for a person in a vegetative state is secondary infection such as pneumonia which can occur in patients who lie still for extended periods.
Occasionally people come out of coma after long periods of time. After 19 years in a minimally conscious state, Terry Wallis spontaneously began speaking and regained awareness of his surroundings. [6]
A brain-damaged man, trapped in a coma-like state for six years, was brought back to consciousness in 2003 by doctors who planted electrodes deep inside his brain. The method, called deep-brain electrical stimulation (DBS) successfully roused communication, complex movement and eating ability in the 38-year-old American man who suffered a traumatic brain injury. His injuries left him in a minimally conscious state (MCS), a condition akin to a coma but characterized by occasional, but brief, evidence of environmental and self-awareness that coma patients lack. [7]
See also
References
Additional Resources
Template:Cognition, perception, emotional state and behaviour symptoms and signs
Template:SIB
ast:Coma (médicu)
bs:Koma
bg:Кома
da:Koma
de:Koma
et:Kooma
eo:Komato
hr:Koma
id:Koma (medis)
it:Coma
he:תרדמת
ka:კომა
lt:Koma
nl:Coma (geneeskunde)
no:Koma
simple:Coma
sk:Kóma
sr:Кома
fi:Kooma
sv:Koma
Template:WH
Template:WS