Coma

Coma

Definition
Unrousable unresponsiveness.

Causes of coma

1)Metabolic:
Drugs, poisoning, eg carbon monoxide, alcohol, tricyclics
Hypoglycaemia, hyperglycaemia (ketoacidotic, or HONK, p816)
Hypoxia, CO2 narcosis (COPD)
Septicaemia
Hypothermia
Myxoedema, Addisonian crisis
Hepatic/uraemic encephalopathy

2)Neurological:
Trauma
Infection meningitis; encephalitis, eg Herpes simplex give IV aciclovir if the slightest suspicion,

3)tropical: malaria ( do thick films), typhoid, rabies, trypanosomiasis

4)Tumour: cerebral/meningeal tumour
Vascular, subdural/subarachnoid haemorrhage, stroke, hypertensive encephalopathy
Epilepsy: non-convulsive status or post-ictal state