Doctor insights on:
Coming Out Of Coma Symptoms
Lethargy, drowsiness: There are stages of coma, measured on the glasgow coma scale. So symptoms will depend on the depth of the coma. However as one goes into a coma it may be sudden loss of consciousness due to acute head trauma, or a gradual slide as with a subdural bleed. The latter is more like a person getting progressively drunk, losing coordination or slowly falling asleep. ...Read more
Yes: When a coma is prolonged for days or even months, there can be a lot of symptoms when that person wakes up. There is usually a great deal of thinking difficulty, the person will often become very agitated at first, they may not remember people they knew before. There may be paralysis of one or more limbs. The longer the coma, usually the more severe the symptoms. However, improvement happens. ...Read more
Can one person without being in a coma have abnormal posturing? What are the causes of this symptom? Thanks.
Yes!!: Abnormal posturing can occur in a large variety of conditions from psychiatric states (e.g. Catatonic schizophrenia) to organic conditions including drug reaction, cerebral palsy, extrapyramidal disorders (such as chorea, parkinson's disease, hemi ballismus dystonia's etc) the list is not exhaustive! ...Read more
Medical emergency: Myxedema coma is a medical emergency and needs to be treated in the hospital. The symptoms for myxedema is vey similar to adrenal insufficiency and often times, patient will need treatment for both while labs are done. With proper treatment, patient can gradually improve, if the symptoms go away quickly, then you did not have myxedema coma. ...Read more
I have had severe food comas and food-induced insomnia for months. These symptoms appear related to portion sizes rather than specific foods. Causes?
Neuro-reflex: When the stomach becomes full there is a neurological reflex that tries to shut down the body in order to facilitate digestion. This causes a state of severe lethargy (coma?). However the body also stays alert to protect from danger - unable to sleep. You are expressing more of this reflex than normal. Get a thorough medical evaluation. Try frequent small meals with less carbohydrates. ...Read more
Coming out of coma with very brief muscle spasms (posturing?) but has gcs of 8/9. Does this mean better chance of recovery?
Patient coming out of coma from ruptured avm is 'posturing', but also responding to pain/cold (makes faces) and has eyes focused. Is this abnormal?
It may be expected: Recovery may take a long time. Only time will tell if what you describe is a good sign of recovery or an automatic nervous system response. ...Read more
Coma: Think of the brain as having a wake and sleep center. When something bad happens to the wake center of the brain, it can no longer do its job to keep the brain awake in the spectrum of maintaining cousiousess. This can be from an anatomic/structural and/or physiological problem. Some of these are reversible and some are unfortunately not. ...Read more
Brain injury: Deep centers of the brain control the ability to react to our environment and control our basic needs. When these deep centers are damaged we lose the ability to react and control. This is described as a state of coma. Brain swelling, brain infection, brain hemorrhage, stroke, trauma, all can result in a state of coma. Recovery depends on the degree of initial damage. ...Read more
Redirection of blood: Even though there is a dramatic increase in blood flow to the stomach and intestines after a meal (proven by ultrasounds) it is thought that it is the increased parasympathetic nervous system activity (opposite of the fight or flight sympathetic activity) which causes the feeling of lethargy. ...Read more
Multifactorial: Coma means unarousable unresponsiveness. It is caused by injury to both cerebral hemispheres or the central brain stem or both. The cause is either traumatic or non traumatic. Non traumatic causes are many - anoxic/ischemic, metabolic, endocrine, infectious, degenerative, etc. It is a clinical term with many disease types as cause. ...Read more
Difficult question: It depends if the underlying reason that caused the coma is reversible or correctable. Even then it is difficult as it depends if there was too much insult to the brain or not. Recovery from coma is such a variable thing that it is difficult to answer without knowing about the specific situation. I wish I could be of more help on this, its just such a complicated thing. ...Read more
Resolution: Coma affects the base of the brain, brainstem, the same area responsible for concussion outcomes. As a disorder heals, and inflammation or swelling decreases, gradually the reticular activating system switches back on, and responses resume. However, on occasion this can be a lengthy restoration, maybe even months and very rarely yrs. ...Read more
Please clarify: Are you asking, "When people in comas die, what do they die of? " Or do you mean, "I don't understand why people in comas die instead of everyone getting better, waking up, shaking their doctor's hand, waving to the nurses, and going home."? Please repost your question so that it can be understood. ...Read more
Unsure: Hard to say. I frequently take care of patients in medically-induced (medication) comas and comas from trauma/strokes. I have never had a patient wake up and give me an assessment. Those that do wake up, do not recall the events. ...Read more
Coma: People emerge from coma in varied fashions and to different extents. For example, people who are in medically-induced comas may emerge from this as medication is allowed to wear off. Alternatively, a person in a coma from a disease state may emerge from coma as the disease state improves. This can be rapid (hours to days) or slow (weeks or months). Some people fully recover. Others may not. ...Read more
The general broad categories of coma include (but not limited to):
1. structural: such as tumor, stroke, bleeding...etc
2. Metabolic/toxic: such as inborn errors of metabolism in children, hepatic encephalopathy, and drug/toxin ingestion/overdose
3. infectious: due to viral encephalitis, bacterial meningitis. etc ...Read more
Not sure: Interesting question. I am not sure they age faster but certainly variious symtems in the body do not work as well and are subject to deterioration from lack of use. This is particularly true for the nervous system and the musculoskeletal system. ...Read more