Coma (patient information): Difference between revisions
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| ICD9 = {{ICD9|780.01}} | | ICD9 = {{ICD9|780.01}} | ||
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{{ | {{Coma (patient information)}} | ||
{{CMG}}; | {{CMG}}; '''Associate Editor(s)-In-Chief:''' Jinhui Wu, M.D. | ||
==Overview== | ==Overview== | ||
A coma is not a specific disease. Instead, it is a deep state of unconsciousness, during which an individual is not able to respond to stimulation. Coma can be caused by underlying diseases, including [[stroke]], head injury, [[seizure]]s, [[brain tumor]]s, brain [[infection]]s, [[hypoxia]], and diabetic hyperosmolar coma or [[hypoglycemia]]. The main signs of coma is [[loss of consciousness]]. Meidcal history, [[physical examination]], neurological evaluation and head images may help find the cause of coma. Patients with coma require immediate treatment in order to avoid serious consequences. Treatments include treating the underlying diseases, maintaining a healthy physical state, preventing infections, and [[physical therapy]]. The prognosis of coma depends on the underlying causes, the severity and the site of neurological damage. Someone can recover, while some may keep in a [[vegetative state]]. | A coma is not a specific disease. Instead, it is a deep state of unconsciousness, during which an individual is not able to respond to stimulation. Coma can be caused by underlying diseases, including [[stroke]], head injury, [[seizure]]s, [[brain tumor]]s, brain [[infection]]s, [[hypoxia]], and diabetic hyperosmolar coma or [[hypoglycemia]]. The main signs of coma is [[loss of consciousness]]. Meidcal history, [[physical examination]], neurological evaluation and head images may help find the cause of coma. Patients with coma require immediate treatment in order to avoid serious consequences. Treatments include treating the underlying diseases, maintaining a healthy physical state, preventing infections, and [[physical therapy]]. The prognosis of coma depends on the underlying causes, the severity and the site of neurological damage. Someone can recover, while some may keep in a [[vegetative state]]. | ||
==What are the symptoms of | ==What are the symptoms of Coma?== | ||
Coma is not a disease but a condition, which can be caused by many disorders. | 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. | *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. | ||
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:*If the breathing muscles are affected, the patient may show irregular breathing. | :*If the breathing muscles are affected, the patient may show irregular breathing. | ||
:*No response to external stimuli | :*No response to external stimuli | ||
Diseases with similar symptoms are: | |||
:*[[Syncope (patient information)|Syncope]] | |||
:*[[Epilepsy (patient information)|Epilepsy]] | |||
:*[[Dizziness (patient information)|Dizziness]] | |||
:*[[Hysteria]] | |||
==Who is at highest risk?== | ==Who is at highest risk?== | ||
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:*[[Liver failure]] or [[kidney failure]] | :*[[Liver failure]] or [[kidney failure]] | ||
== | ==When to seek urgent medical care?== | ||
When you find someone in coma, call 911 as soon as possible. | |||
==Diagnosis== | |||
The goal of the following tests is to identify the cause of coma. | The goal of the following tests is to identify the cause of coma. | ||
:*[[Medical history]], [[physical examination]] and [[neurological evaluation]]: These measurements may be very important to find the cause of coma. | :*[[Medical history]], [[physical examination]] and [[neurological evaluation]]: These measurements may be very important to find the cause of coma. | ||
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:*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. | :*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 [[seizure]]s. | :*[[Electroencephalography]] ([[EEG]]): This test can demonstrate the electrical activity in the brain and be used to rule out [[seizure]]s. | ||
==Treatment options== | ==Treatment options== | ||
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:*[[Physical therapy]] may be used to prevent [[contracture]]s and deformities of the bones, joints, and muscles. | :*[[Physical therapy]] may be used to prevent [[contracture]]s and deformities of the bones, joints, and muscles. | ||
== | ==Where to find medical care for Coma?== | ||
: | [http://maps.google.com/maps?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|map+top+hospital+Coma}}}}&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wl Directions to Hospitals Treating Coma] | ||
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: | |||
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==Prevention of Coma== | |||
==Prevention of | |||
:*Treating your brain diseases | :*Treating your brain diseases | ||
:*For [[diabetes]] patients, maintaining glucose in a normal level | :*For [[diabetes]] patients, maintaining glucose in a normal level | ||
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:*The site of neurological damage | :*The site of neurological damage | ||
== | ==Possible complications== | ||
*Patient may remain in coma for an extended period | |||
*Death | |||
==Sources== | |||
http://www.ninds.nih.gov/disorders/coma/coma.htm | http://www.ninds.nih.gov/disorders/coma/coma.htm | ||
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[[Category:Neurology]] | [[Category:Neurology]] | ||
[[Category:Neurology patient information]] | [[Category:Neurology patient information]] | ||
[[Category:Overview complete]] | |||
[[Category:Template complete]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Revision as of 14:59, 3 August 2011
For the WikiDoc page for this topic, click here
| Coma | |
| ICD-10 | R40.2 |
|---|---|
| ICD-9 | 780.01 |
|
Coma |
|
Coma On the Web |
|---|
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Jinhui Wu, M.D.
Overview
A coma is not a specific disease. Instead, it is a deep state of unconsciousness, during which an individual is not able to respond to stimulation. Coma can be caused by underlying diseases, including stroke, head injury, seizures, brain tumors, brain infections, hypoxia, and diabetic hyperosmolar coma or hypoglycemia. The main signs of coma is loss of consciousness. Meidcal history, physical examination, neurological evaluation and head images may help find the cause of coma. Patients with coma require immediate treatment in order to avoid serious consequences. Treatments include treating the underlying diseases, maintaining a healthy physical state, preventing infections, and physical therapy. The prognosis of coma depends on the underlying causes, the severity and the site of neurological damage. Someone can recover, while some may keep in a vegetative state.
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
Diseases with similar symptoms are:
Who is at highest risk?
- 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
When to seek urgent medical care?
When you find someone in coma, call 911 as soon as possible.
Diagnosis
The goal of the following tests is to identify the cause of coma.
- Medical 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.
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.
Where to find medical care for Coma?
Directions to Hospitals Treating Coma
Prevention of Coma
- Treating your brain diseases
- For diabetes patients, maintaining glucose in a normal level
- Avoidance of contacting with toxin
What to expect (Outlook/Prognosis)?
Some patients with coma can recover, while others may keep in a vegetative state. The prognosis depends on:
- The underlying causes
- The severity
- The site of neurological damage
Possible complications
- Patient may remain in coma for an extended period
- Death