Reversible coma with prolonged absence of pupillary and brainstem reflexes: an unusual response to a hypoxic-ischemic event in MS.
A quadriparetic man with multiple sclerosis became comatose with absent pupillary and brainstem reflexes for 48 hours following a respiratory arrest. A periodic electroencephalographic pattern was recorded 12 hours after arrest suggesting a poor prognosis. Despite the poor prognostic signs, clinical recovery to baseline occurred within 2 weeks. Reversible coma with absent pupillary and brainstem reflexes may occur in MS patients for prolonged periods and lead to potential errors in prognosis if not recognized.
Ringel
R A
RA
Department of Neurology, West Virginia University School of Medicine, Morgantown 26506.
Riggs
J E
JE
Brick
J F
JF
D002545:Brain Ischemia / Q000150:complications / Q000503:physiopathology; D001933:Brain Stem / Q000503:physiopathology*; D003128:Coma / Q000209:etiology / Q000503:physiopathology*; D004569:Electroencephalography; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000503:physiopathology*; D012018:Reflex; D012025:Reflex, Pupillary