DISEASES OF THE NERVOUS SYSTEM : COMA - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Coma is a deep state of unconsciousness with no reaction to external and internal stimuli. The reason comatose States can be a variety of diseases:
All these factors cause the cerebral circulation and its toxicity that may lead to edema and hypoxia. Occurs braking as cortical functions, and other parts of the brain.
Symptoms. Coma often develops suddenly, rarely gradually. The main symptom is loss of consciousness. Disturbed the rhythm of breathing: type Cheyne-Stokes equations, Biota, type Kussmaul (diabetes). The pulse slows or quickens. Blood pressure often increases. Often delirium, restlessness. Often vomiting, various breath. Roving eyes, the expansion or contraction of the pupils. Often have involuntary movements, meningeal symptoms. Reflexes (tendon, skin, cornea) usually disappear immediately or upon increase of the coma, there may be pathological reflexes (Bubenikova, Rossolimo, protective) and various automatisms (grasping reflexes of oral automatism).
As coma can accompany a variety of diseases, while recognizing it is necessary to thoroughly consider the history, age, all the circumstances that preceded the coma held treatment, former seizures, possible poisoning. Carefully consider the coma and the whole symptomatology - neurological and somatic. Explores the breath, urine, blood, blood pressure.
The prognosis depends on etiology. Drawstring coma always overshadows the forecast.
Treatment - depending on the etiology. The fight against intoxication (gastric lavage, saline, intravenous glucose); regulation of respiration and cardiac activity; control swelling of the brain (glucose, sulphate of magnesia). Upon excitation drugs: chloral hydrate, hemicalname, veronal. If necessary, cupping, lowering blood pressure means. Prolonged vomiting - subcutaneous atropine.