Coma: Symptoms, Causes, Diagnosis & Treatments

A coma is a state in which a person is not conscious. In this state, a person does not respond to the environment. The person is breathing or alive but it looks like he or she is in deep sleep. But it is different from a deep sleep as in deep sleep you can awake a person by any stimulation which is not possible in a coma. A person enters a coma due to an injury to the head. There can be various reasons for brain injury including bleeding, increased pressure, lack of oxygen or toxins builds up. It is a medical emergency which requires immediate treatment in order to save life and functioning of the brain.

A lot of people have this question in mind that: What is the level of consciousness or responsiveness of a person who is in a coma? It totally relies on the how much brain of a person who is in a coma is functioning. Generally, people are in a coma for some days or week. Though it can also last for many years,  this case is very rare.

Symptoms of Coma

If a person is in a coma then he or she would not be able to communicate and respond to the environment. Check out the various symptoms of a coma:

- In a coma, eyes of a person are closed.

- People who are in a coma breathe irregularly.

- A person does not respond to painful stimuli, except for involuntary movements.

- Limbs do not respond, except for involuntary movements.

- People do not talk and respond to the environment.

Due to a severe injury to the brain, sometimes, a person enters into a coma. If the reason is severe injury then there are chances that symptoms may become visible suddenly. As soon as you discover the symptoms or signs of a coma in a person, you should admit him or her to the hospital immediately for the treatment as it is a medical emergency.

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Causes of Coma

A lot of problems can lead to a state of prolonged unconsciousness. Check out some of the possible causes of a coma:

- Trauma: Due to head injuries, the brain can swell or start to bleed. The brain swelling can push the fluid against the skull. Due to this, the reticular activating system of the brain can damage that is responsible for awareness and arousal. So, trauma can lead to a state of a coma.

- Infections: If a person has the inflammation in the spinal cord, brain and tissues that surround the brain then a coma can result. Some of the examples include meningitis or encephalitis.

- Diabetes: Hypoglycemia is the problem of low blood sugar. In hyperglycemia, the blood sugar is abnormally high. Any of the problems including hypoglycemia or hyperglycemia if continues for a long time then it can lead to a coma.

- Hypoxia: Due to hypoxia, enough oxygen could not reach to the various organs of the body. If the brain does receive enough oxygen as required during a stroke, heart attack, or about to drowning condition then a state of a coma can occur.

- An overdose of toxins and medicine: Due to overdoses of some drugs, a person can enter into a coma. Carbon monoxide can lead to brain damage or a coma.

- Seizures: A state of a coma rarely occurs due to only one seizure. But due to continuous seizures, a person can enter a coma. Because of continuous seizures, the brain is not able to recover between seizures.

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How Coma is diagnosed?

Those people who are in a coma are not able to respond. That is why doctors seek information from the family and friends of the patient. The doctor generally asks the information from the person who was with the patient before the coma started. This helps the doctor to find out the underlying cause of a coma. In addition to this, doctors seek for other information including:

- The doctor will ask whether it happened to patient suddenly or in some time.

- The doctor will ask about the various signs that were noticed before the coma started.

- Your doctor might ask if the patient was taking some prescribed drugs, over-the-counter medicines, and recreational drugs.

- The doctor can ask about the recent changes in health or behaviour of the patient that was noticed by the family members or friends before the coma started.

- The doctor may ask about the medical history of the patient.

Check out the various tests that will be done by the doctor in order to diagnose:

1. Physical examination: The doctor conducts a physical examination in which he checks the size of the pupil, reflexes and movements and response of the patient to painful stimuli. The doctor will also check the patterns of breathing in order to diagnose the underlying cause. The doctor will look for the symptoms of arousal including eyes opening, vocal noises or movement. The doctor may speak loudly in order to check the level of consciousness of the patient. To find out the cause of a coma and the location of brain injury, the doctor will also test reflexive movements of the eye.

2. Laboratory tests: Various blood tests will be done to find out the complete count of blood, overdose of medicine or alcohol, carbon monoxide (CO) poisoning and glucose, thyroid, electrolytes, liver and kidney function. A spinal tap which is also known as lumbar puncture help to check the symptoms of infections in the affected person's nervous system. In this medical procedure, the doctor collects a little fluid from the spinal cord by inserting a needle for the purpose of analysis.

3. Brain scans: Various imaging tests are conducted by the doctor to find out the places of injury in the brain. These imaging tests include a computerized tomography scan (CT scan), electroencephalography (EEG), and magnetic resonance imaging (MRI).

- Computerized tomography scan (CT scan): A computerized tomography scan is done to diagnose the underlying cause of a coma. With the help of a CT scan, one can see tumours, strokes, brain haemorrhage and other problems.

- Magnetic resonance imaging (MRI): In this, magnets and radio waves that are powerful are used to create a detailed brain's view. These are very helpful for the examination of the deep brain structures and brainstem.

- Electroencephalography (EEG): An electroencephalography helps to measure the electrical activity of the brain. In this scan, the doctor attached tiny electrodes to the patient's scalp. A low electrical current is sent by the doctor through the tiny electrodes. This helps to find out if seizures are the cause of a coma.

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Prevention of Coma

Check out the various ways to prevent yourself from a coma:

- People generally enter a coma due to traffic and road accidents. So, make sure that you follow the laws of traffic and safety.

- A diabetic coma is a serious problem related to diabetes. Diabetes can lead to a coma. In order to prevent yourself from a diabetic coma, you should follow various guidelines including:

- You should stick to a healthy diet.

- You should do the physical exercises daily.

- You should reduce or avoid the consumption of alcohol.

- You should drink a lot of water.

Treatment of Coma

A coma is a medical emergency that requires immediate treatment so that the life of a person can be saved and the brain can be prevented from damage. The treatment totally relies on the cause of a coma. Friends or family members should provide all the relevant information to the doctor so that he or she can rule out the underlying cause of a coma. It is important that the treatment starts as early as possible so that some conditions can be reversed. Check out the various treatment options available for the patients suffering from a coma:

- If the doctor finds out that the patient has an infection in the brain then he or she may prescribe the antibiotics to reduce the infection that is creating the problem.

- Sometimes, the doctor may prescribe to go for a surgery. The surgery is required to ease the brain pressure that is because of swelling or for removing a tumour.

- Certain medicines may be prescribed by the doctor for relieving the patient from the swelling.

- Sometimes, medicines are given to stop the problem of seizures, if required.

- Patients who are in a coma are kept in an intensive treatment unit and they generally need full life support until their condition improves.

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What is the Complications in Coma

Check out the various complications associated with a coma:

- High risk: The people who are in a coma, their life is at high risk. A coma can last for some days or weeks. In some situations, it can also last for several years. If not treated properly on time or left untreated then it can become life-threatening.

- Persistent vegetative state: After the two to four weeks in a vegetative state, the affected person is classified as in a persistent vegetative state. If a person is in a persistent vegetative state then there are very low chances of full recovery.

- Skeletal or muscular atrophy, or bed sores: As the patients who are in a coma are not able to move and respond so a coma state can result in skeletal or muscular atrophy or bed sores.

Myths

Myth #1: A coma is a state of deep sleep.

It is a very common myth that a lot of people have. As per various people, a coma is a state of deep sleep. But it is a misconception. In a vegetative state, the eyes of the patient are open and also move. The person in a vegetative state sleeps and wakes up too. But the person is not conscious and can not respond.

Conclusion

A coma is a state in which a person is unconscious and not able to respond to the environment. Generally, a person enters a coma due to an injury to the head. It is a medical emergency that should be treated as early as possible to save the life of the patient and prevent the brain from damage. Closed eyes, irregular breathing, no response to painful stimuli, no response in limbs, no response to the environment and more are some of the symptoms of a coma. Symptoms may vary from person to person. Trauma, seizures, infections, diabetes, hypoxia, toxins and medicines overdoses are some of the causes that can result in a coma state.

As the person who is in a coma cannot speak or respond, the doctor asks the information about the patient from the family members or friends. The information helps the doctor to rule out the underlying cause of a coma. The doctor may ask to get the various blood tests and brain scans done to find out the relevant information. In order to prevent self from a coma state, one should follow the safety and traffic laws as mostly people enters a coma due to traffic and road accidents. A life-threatening problem, skeletal or muscular atrophy, bed sores, and persistent vegetative state are some of the complications associated with a coma.

If you are for the answer to various questions including:

- What is a coma?

- What are the causes, symptoms, complications, and myths of a coma?

- How is a coma diagnosed, prevented and treated?

Then you are in the right place, please refer to the above-mentioned information.

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Last updated on : 04-01-2019

Disclaimer : Docprime doesn’t endorse or take any guarantee of the accuracy or completeness of information provided under this article and these are the views strictly of the writer. Docprime shall not be held responsible for any aspect of healthcare services administered with the information provided on this article.

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