COMA AND CHANGES IN MENTAL STATUS


Click here for Glasgow Coma Scale

"AEIOU TIPS"-Differential dx for coma

  1. Alcohol-related
  2. Encephalopathy
  3. Insulin (hypoglycemia, hyperglycemia too)
  4. Opiates
  5. Uremia
  6. Trauma
  7. Infection
  8. Psychiatric
  9. Syncope

Causes of stupor/coma in series of 500 pts with initial dx of "Coma of unknown etiology":

1. Supratentorial lesions101

2. Subtentorial lesions 65

3. Diffuse/metabolic brain dysfn326

4. Psychiatric "coma" 8

n.b. 1 & 2 should give focal Px findings

(Plumb & Posner, Stupor and Coma)

 

 

Management of coma with uncertain dx:

Establishing prognosis in comatose patient after cardiac arrest: