What are the signs and symptoms of someone in a coma?

Signs of coma include unresponsiveness, lack of reaction to stimuli like light or sound, absence of voluntary movement, and no sleep-wake cycle. Some individuals may exhibit reflexive movements or responses, but they are unaware of their surroundings.

How is a coma diagnosed?

Diagnosis involves a comprehensive medical evaluation, including neurological exams, imaging tests such as CT or MRI scans to assess brain function and structure, and sometimes EEG (electroencephalogram) to measure brain activity.

What is the outlook for someone in a coma?

The prognosis varies depending on the cause, severity, and duration of the coma. While some individuals may fully recover, others may experience long-term disabilities or remain in a vegetative state. Healthcare providers communicate the prognosis with the family based on individual circumstances.

3846
3.2 Minute

13-07-2024 Team Medicover Neurology

Coma: Stages and Medication

Q: What are the causes of coma?

Coma may result from various conditions including stroke, traumatic brain injury (TBI), brain tumors, infections (such as meningitis or encephalitis), drug overdose, metabolic disorders (like diabetic coma), severe hypoxia (lack of oxygen), and other neurological conditions.

Q: Can someone wake up from a coma?

Yes, some individuals can gradually emerge from a coma, progressing through stages of increased responsiveness and awareness. Recovery chances depend on the underlying cause and extent of brain damage.

Q: How can family and caregivers support someone in a coma?

Support includes providing comfort, speaking to the person as if they can hear, playing familiar music or sounds, maintaining their physical care, participating in rehabilitation efforts if they begin to wake up, and seeking emotional support for themselves during this challenging time.

People frequently hear the word "coma" in news reports and movies. But many are not aware of its causes, diagnoses, and treatments. Let's discuss coma, including its causes and available treatments.

What is a Coma?

A coma is a prolonged unconscious state caused by various factors, including head trauma, stroke, brain tumour, or medication. Secondary conditions like diabetes or an infection can also trigger a coma.

Here are a few signs a person in a coma shows:

In a coma, the person is alive, but they don't react to the world around them, and their brain is very inactive.
A person in a coma will be unaware of the surroundings and appear asleep. Unlike deep sleep, they cannot be woken up by any stimulation, including pain.
A coma is recognized as a medical emergency, and doctors will do a series of blood tests and a brain scan to identify the cause of it and begin an appropriate treatment plan.
A persistent vegetative state, also called brain death, can occur in people who have been unconscious for a long time.

Secure your health with a second opinion. Make informed decisions and book your appointment today!

Get A Second Opinion

What Triggers a Coma in a Person?

Head traumas or problems with cerebral blood flow account for more than 50% of all comas.
Brain injury can be caused by high blood pressure, hemorrhage, oxygen deprivation, or toxin buildup.
Brain damage can be temporary and reversible, but it can also be permanent.

Coma can be caused by the following factors:

Hepatitis

Head traumas or problems with cerebral blood flow account for more than 50% of all comas.
Brain injury can be caused by high blood pressure, hemorrhage, oxygen deprivation, or toxin buildup.
Brain damage can be temporary and reversible, but it can also be permanent.

Anoxic Brain Damage

This neurological disorder is caused due to the brain receiving no oxygen. Even a few minutes of no oxygen causes brain tissue cells to die.
A heart attack (cardiac arrest), a head injury or trauma, drug overdose, drowning, or poisoning can all result in anoxic brain damage.

Swelling

All swelling does not have to be caused by trauma. A lack of oxygen, an electrolyte imbalance, or severe infections can lead to swelling.

Head Injuries

Head injuries can cause brain hemorrhage or swelling.
The brain fluid exerts pressure on the skull due to trauma.
As the brain expands, it puts pressure against the brain stem, damaging the RAS (Reticular Activating System).

Internal Bleeding

A wound can cause a part of the brain to swell and compress, allowing blood to seep into the brain's layers.
The RAS and brainstem are damaged when the brain moves as a result of the pressure. It could put anyone in a coma.
High blood pressure and cancer are two non-traumatic causes of brain bleeding.

Stroke

Severe strokes can leave a person unresponsive or in a deep sleep-like state like unconsciousness or coma.

Seizures

A single seizure seldom causes a coma. Constant seizure episodes can result in a coma.
Regular seizures might make it harder for the brain to recover between episodes, which could put someone in this condition.

Blood Sugar

If a person's blood sugar levels remain extremely high, he or she may fall into a coma.
This coma usually recovers once the blood sugar is stabilized. However, chronic hypoglycemia can result in lifelong brain damage and unconsciousness.

Infections

Coma can also result from neurological illnesses such as meningitis and encephalitis.

Heart Problems

The brain needs oxygen to function properly. A sudden cardiac arrest might cut off the brain's supply of oxygen and blood, resulting in a coma.

Toxins

Some chemicals, such as ammonia, carbon dioxide, and urea, can accumulate to toxic levels in the body if not eliminated. Large levels of alcohol and drugs can also damage neuron function in the brain.

Ready to take control of your health journey? Book your appointment now and start your path towards wellness today!

Book an Appointment

Stages of a Coma

Eye Opening Response

Spontaneous: The individual opens their eyes independently.
To verbal stimuli: They open their eyes in response to speech or noise.
To pain: They open their eyes when experiencing pain.
None: They do not open their eyes at all.

Verbal Response

Oriented: They can accurately answer questions about their identity, location, and time.
Confused: They respond, but their answers could be clearer.
Inappropriate words: They speak words that are not relevant to the conversation.
Incomprehensible sounds: They make sounds, but their speech is not understandable.
None: They do not make any sounds or respond verbally.

Motor Response

Obeys commands: They can carry out instructions, such as squeezing a hand or raising an arm.
Localizes to pain: They move or react to the location of pain, but not necessarily to commands.
Withdraws from pain: They pull away or move when experiencing pain.
Abnormal flexion: Their arms are bent and their legs are straight, showing a specific reaction to pain.
Extension: Their arms and legs are straight, indicating a different reaction to pain.
None: They do not move or respond to any stimuli.

These stages of coma scoring systems assist medical professionals in determining the depth of unconsciousness in a patient and tailoring treatment accordingly.

What Happens in a Hepatic Coma?

Liver dysfunction can lead to hepatic coma, which confuses, changes in behaviour, and even loss of consciousness because of toxin buildup. When the liver isn't working properly, it can cause;

Hepatic coma
Leading to confusion
Behaviour changes
Possibly loss of consciousness

What Happens in a Diabetic Coma?

Diabetic coma occurs in severe cases of uncontrolled diabetes, where blood sugar levels become dangerously high (hyperglycemia) or low (hypoglycemia), leading to unconsciousness or near-unconsciousness.

Is There an Effective Medication for Coma?

Comas are mainly treated with supportive care in an intensive care unit and often need life support until their condition improves. Also, the treatment of a coma is dependent on the causative substance. With immediate medical attention, a possibly curable coma can be treated.

If a brain infection is a reason, doctors may prescribe antibiotics.
In the case of a diabetic coma, the body may need glucose, which may solve the problem.
Surgery may be necessary to remove a tumour or relieve pressure on the brain if edema is the cause.
Medication can also help with swelling. The same is true for seizures, which can also be treated with medication.

Note

Brain death differs from a coma. A coma gives the chance for reversal, while brain death is irreversible.

Conclusion:

When someone is in a coma, it might be difficult to predict their recovery. Each patient is unique. Therefore, it is critical to consult with a healthcare provider.

Many patients can wake up from a coma after a few weeks. However, they might be quite disabled. It is, nevertheless, always advisable to get medical help.

Frequently Asked Questions

A coma may result from a stroke, traumatic brain injury (TBI), brain tumors, infections (such as meningitis or encephalitis), drug overdose, metabolic disorders (like diabetic coma), severe hypoxia (lack of oxygen), and other neurological conditions.

Signs include the person being unresponsive, not reacting to stimuli like light or sound, no voluntary movement, and no sleep-wake cycle. Some may show reflexive movements or responses, but they are not aware of their surroundings.

Diagnosis involves a thorough medical evaluation, including neurological exams, imaging tests (like CT or MRI scans) to assess brain function and structure, and sometimes EEG (electroencephalogram) to measure brain activity.

Prognosis varies depending on the cause, severity, and duration of the coma. Some individuals may recover fully, while others may have long-term disabilities or remain in a vegetative state. It's essential for healthcare providers to assess and communicate the prognosis with the family.

Yes, some individuals gradually emerge from a coma, transitioning through stages of increased responsiveness and awareness. The chances of recovery depend on the underlying cause and extent of brain damage.

Support includes providing comfort, talking to the person as if they can hear, playing familiar music or sounds, maintaining their physical care, participating in rehabilitation efforts if they begin to wake up, and seeking emotional support for themselves during this challenging time.

Book Doctor Appointment

Name*

Mobile Number*

I agree to the Medicover Privacy Policy

International Patient Services