Diagnosis of Coma

Emerg Med Clin North Am. 2021 Feb;39(1):155-172. doi: 10.1016/j.emc.2020.09.009. Epub 2020 Nov 5.

Abstract

The differential diagnosis for the comatose patient is includes structural abnormality, seizure, encephalitis, metabolic derangements, and toxicologic etiologies. Identifying and treating the underlying pathology in a timely manner is critical for the patient's outcome. We provide a structured approach to taking a history and performing a physical examination for this patient population. We discuss diagnostic testing and treatment methodologies for each of the common causes of coma. Our current understanding of the mechanisms of coma is insufficient to accurately predict the patient's clinical trajectory and more work needs to be done to investigate potential treatments for this often fatal disorder.

Keywords: Coma; Disorders of consciousness; Neurocritical care.

Publication types

  • Review

MeSH terms

  • Coma / diagnosis*
  • Coma / etiology
  • Coma / therapy
  • Diagnosis, Differential
  • Emergency Service, Hospital
  • Humans
  • Physical Examination
  • Vital Signs