Coma (patient information)

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What is coma?

How do I know if I have coma and what are the symptoms of coma?

Coma is not a disease but a condition, which can be caused by many disorders.

Onset time: When a patient suffers a hemorrhage stroke or severe head trauma, coma may start suddenly. While for a person with alcohol abuse or some kind of drugs, the progress of unconsciousness may be slowly.
Antecedent symptoms before coma, depending on the underlying disease: If the coma is caused by alcohol abuse or some kind of drugs, patients may experienced mildly confusion, drowsy or personality change in the beginning. If the underlying cause is a brain infection, patients may show signs including headache, fever, or dizziness before the actual coma develops. In some cases, coma may happen so quickly that patients or their families don't have time to notice.
Signs of coma

Loss of consciousness
Some spontaneously movements, including shaking, tremors, and jerking movements.
Eyes' abnormal movement
If the breathing muscles are affected, the patient may show irregular breathing.
No response to external stimuli

Who is at risk for coma?

A hemorrhagic or ischemic stroke
A severe head injury
Seizures
Brain tumor
Brain infections
Hypoxia for a long time
Metabolic abnormalities, such as diabetic hyperosmolar coma, hypoglycemia
Toxins, including poisons, alcohol and other drugs (barbiturates, sedatives, amphetamines, cocaine)
Liver failure or kidney failure

How to know you have coma?

The goal of the following tests is to identify the cause of coma.

Meidcal history, physical examination and neurological evaluation: These measurements may be very important to find the cause of coma.
Eye examination: It is also very useful to identify underlying problem in the brain.
Laboratory tests: These tests include the check of liver function, kidney function, glucose levels, thyroid function, even the presence of any toxins. The results of the various lab tests may provide clues to detect some metabolic diseases which can cause coma.
Imaging studies such as head CT (computerized axial tomography) and MRI (magnetic resonance imaging): These images can be used to detect the abnormalities in the brain.
Electroencephalography (EEG): This test can demonstrate the electrical activity in the brain and be used to rule out seizures.

When to seek urgent medical care?

When you find someone suffers from coma, call 911 as soon as possible.

Treatment options

Patients with coma require immediate treatment in order to avoid serious consequences. Treatments depend on the underlying cause.

Treatments on the underlying diseases, such as a emergent surgery for a hemorrhage stroke, antibiotics for brain infections, maintenance of normal glucose for diabetes, alexipharmic for toxins, dialysis for kidney failure.
Maintaining a healthy physical state, providing balanced nutrition
Preventing infections, such as preventing pneumonia and bedsores.
Physical therapy may be used to prevent contractures and deformities of the bones, joints, and muscles.