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Of the studies in Asia, encephalitides were the commonest cause of coma in two studies in India, and ABM was the commonest cause of coma in Pakistan. Manifestations of cerebral dysfunction include any degree of impaired consciousness, delirium, abnormal neurological signs, and focal and generalized convulsions. She was put into an induced coma for three weeks to reduce give her body the best chance of recovery. In a comatose state, the patient cannot be awakened and does not respond to pain, light or sound in a normal way – the comatose individual cannot react to the surrounding environment. In addition to those suffering from traumatic brain injury, diabetic patients are at risk for coma from extreme levels of blood sugar. Following mastoidectomy and temporary placement of a lumbar drain, he recovered. We examined how patient outcome at hospital discharge compared with that at long-term follow-up visits, when changes in outcome occurred, and the prognostic indicators of the eventual outcome.

Etiology was classified into infections, toxic-metabolic, hypoxic-ischemic, post-status epilepticus, intracranial bleeding and miscellaneous. Drowsiness and stupor are usually accompanied by some degree of confusion (Chap. Epilepsy, drug intoxication, diabetes, and severe infections were the other major causes for admission. Of the studies in Asia, encephalitides were the commonest cause of coma in two studies in India, and ABM was the commonest cause of coma in Pakistan. His bacterial meningitis-encephalitis struck without warning. Chi-square test and logistic regression analysis were done to determine predictors of outcome. Robertson was so sick that he did not recognise his brother Willie, his wife, or his mother.

However, 12 of 30 patients (40%) survived and 7 patients (23%) had a good functional outcome, defined as a score of 5 on the Glasgow Outcome Scale. Doctors sedated Jep Robertson in the intensive care unit. Confusional state is a more profound deficit that includes disorientation, bewilderment, and difficulty following commands. What are primary headaches? Listeria can cause serious illness including meningitis, septicemia, pneumonia, hydrocephalus, encephalitis, seizure, stroke, coma, blindness, brain stem damage, cranial nerve palsies and cervical cord compression. “We have all been through a terrifying experience,” he added. Dextrose (50 mL of 50% solution in adults) reverses coma secondary to hypoglycemia and is indicated if rapid testing of blood glucose is unavailable.

Diabetes. “The liquid remedy can be slowly dripped into her mouth if she is not responsive.” I had already anticipated the possibility of her choking as you can see from the last paragraph in my last post copied above. It is important to note that there is no single examination finding, score or test that distinguishes between all patients in coma and those who are not. The course will also cover the latest diagnostic and therapeutic approaches to stroke. This is also termed minimal hepatic encephalopathy. What are secondary headaches? Coma may worsen to become a persistent vegetative state.

Attendees are encouraged to bring laptops or tablets to take emergency neurological life support (ENLS) online quizzes. The level of consciousness was assessed by the Glasgow coma scale. The general symptoms of West Nile fever, resulting from infection with WNV, range from fever, rash, and headache to meningitis, encephalitis, coma, and death. Although discussed separately, the assessment and management of children in coma are performed jointly in practice (table 1). Coma due to compression and swelling on the injured side of the brain may occur due to bleeding in the brain layers. Diagnostic Procedures/Other Lumbar puncture (LP): Indicated when the etiology remains unclear after lab and CT scan Empiric antibiotics should be given before LP in patients with suspected meningitis. It may be virally induced but is more often bacterial.

First, I want to talk about Grant Virgin who was actually in a coma and came out of it because of fish oil. Important functions, such as breathing and blood circulation, remain intact. Etiology of coma was determined on the basis of clinical history and relevant investigations. Cortical function is graded from 6 (purposeful, spontaneous movements) to 0 (flaccid), and brainstem function is graded from 3 (intact) to 0 (absent and apneic). The patient does not speak, and there is no purposeful movement of the face or limbs. The eyes are closed and do not open spontaneously. The caller was one of the doctors treating his wife, Donna, who had been in a coma for four months.

Knowledge of the anatomical basis of coma is essential for competent evaluation but must be combined with an understanding of the many, often multi-factorial, medical conditions that result in impaired consciousness. *Corresponding author: Ghasem Miri-Aliabad, Department of Pediatrics, Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, P.O.Box: 9816743111, Zahedan, IR Iran. Central nervous system infections may be complicated by development of severe brain edema, which can be a significant factor in mortality and morbidity. From the Department of Pediatrics, Jawaharalal Institute of Postgraduate Medical Education and Research, Dhanvantri Nagar, Pondicherry 605 006, India.