Approach to the child with coma.
Coma and other states of impaired consciousness represent a medical emergency. The potential causes are numerous, and the critical window for diagnosis and effective intervention is often short. The common causes of non-traumatic coma include central nervous system infections, metabolic encephalopathy (hepatic, uremic, diabetic ketoacidosis etc.), intracranial bleed, stroke and status epilepticus. The basic principles of management include 1) Rapid assessment and stabilization, 2) Focussed clinical evaluation to assess depth of coma, localization of lesion in the central nervous system and possible clues to etiology, and 3) Treatment including general and specific measures. Commonly associated problems such as raised intracranial pressure and seizures must be recognized and managed to prevent secondary neurologic injury.
Sharma
Suvasini
S
Department of Pediatrics, Child Neurology Division, All India Institute of Medical Sciences, New Delhi, 110029, India.
Kochar
Gurpreet Singh
GS
Sankhyan
Naveen
N
Gulati
Sheffali
S
D002494:Central Nervous System Infections / Q000150:complications; D002648:Child; D002985:Clinical Protocols; D003128:Coma / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D004677:Encephalocele / Q000150:complications / Q000175:diagnosis; D006801:Humans; D015278:Intensive Care Units, Pediatric; D007427:Intracranial Pressure; D009460:Neurologic Examination; D009626:Terminology as Topic