Coma is an extended period of unconsciousness

Dr S.H. Mittal,Head & Senior Consultant Neurology, Sharda Hospital,

Coma is a prolonged state of loss of consciousness. It is similar to deep sleep, but the person does not wake up or respond normally. Automatic functions like breathing and circulation can persist normally.

According to Dr S.H. Mittal,Head & Senior Consultant Neurology, Sharda Hospital, “Coma can have a variety of reasons. These can be directly due to a brain pathology such as stroke, brain hemorrhage, and trauma to the head, brain tumor, and brain infection, etc. However, this medical emergency can also result from other problems like infections, electrolyte imbalance, sugar disorders, blood pressure disorders, toxins, lung infections, and conditions, low oxygen levels, etc., that can also reduce brain functions indirectly. A diagnosis is essential but difficult in view of so many problems that can affect the brain. A variety of tests are done – blood tests, EEG, brain scans, CSF analysis, etc. – to arrive at the cause of the coma.”

A person usually has closed eyes, no response to stimuli like light, touch, and pain, etc. The limb movements are usually absent except for possible reflex movements. The breathing is often irregular and patients may need support from the ventilator. Some of the clinical variables are observed such as eye opening, ability to move limbs, and ability to respond verbally, and a scale known as the Glasgow Coma Scale has been established to communicate the coma state and consciousness state effectively. Usually, a coma does not last longer than a few weeks. When a person wakes from a coma depends on the cause of the coma. However, if it lasts longer than that, one may be said to have a vegetative state of brain death. Some problems like urine infection, lung infection, bedsores, etc., may develop due to the prolonged care needed for coma. Therefore, care has to be taken of the nutritional status, skin care, bowel bladder care, and passive exercises to maintain the flexibility of the joints and muscles. The recovery from a coma, unlike the usual movie depiction, is not commonly sudden. It is gradual and slow. The person may start to open their eyes and react to pain or sound. Often, they become agitated or confused while coming out of the coma. And then they may sit and eat and be fully awake.