Coma: Causes, Symptoms, and Long-Term Outlook

A coma is a prolonged state of unconsciousness that occurs when the brain is damaged. The damage can be temporary or permanent, but the severity of the damage caused will dictate the events. Learn the symptoms and diagnosis, along with causes, here.

9 minute read

Last Updated July 8, 2020

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A coma is a prolonged state of unconsciousness, and it occurs when the brain is damaged. Brain damage can be temporary or permanent, but it results in the inability to wake and unresponsiveness to pain, sound, light, and other stimuli.

Being in a coma means that you are alive but unable to move, think, speak, or respond to your environment. A coma is a medical emergency, and patients need to be cared for and kept healthy during its duration. 

What Causes a Coma?

There are two types of coma. The first is related to damage to the brain resulting from bruising or swelling. The second is associated with damage to the brainstem. The causes of coma range from injury to illness, and can also include lifestyle influences such as drugs and alcohol. 

The part of the brain that is specifically damaged in a coma is the diffused bilateral cerebral hemisphere cortex, which is responsible for arousal and awareness. This part of the brain can become damaged by a number of potential factors.

♦ Traumatic brain injuries such as those from a car accident
♦ Tumors in the brain stem
Stroke, which results in reduced blood flow to the brain
♦ Lack of oxygen to the brain from a heart attack or drowning
♦ Carbon monoxide poisoning
♦ Heavy metal poisoning
♦ Repeated seizures
♦ Infections such as meningitis
♦ Diabetes complications
♦ Electrolyte imbalance
♦ Overdosing on alcohol or drugs

Comas have two distinct stages and several intermediary stages. In the first stage, patients are incapable of voluntary activity, and in some cases, primary avoidance responses are absent too (such as the gag reflex and response to pain).

During the second stage, the patient can open their eyes, but they cannot do anything. They do not speak or move or follow commands. This is commonly referred to as a vegetative state.

The Symptoms of a Coma

As a medical emergency, it is vital to identify a coma right away. Signs to look for include:

♦ Closed eyes
♦ Unresponsiveness
♦ Irregular breathing
♦ No response to pain
♦ Pupil unresponsive to light

Diagnosis of a Coma

Once in a coma, you cannot speak for yourself, so doctors rely on those with you to provide information regarding symptoms and potential causes. Events leading up to the coma are important to note, in addition to medical history, lifestyle, and drug use, for diagnosis and treatment purposes. 

A physical exam will be conducted to check reflexes, breathing patterns, evaluate pupil size, and to determine the patient’s response to painful stimuli. Blood tests can also be done to evaluate blood count, electrolyte balance, thyroid and liver function, drug and alcohol use, and identify if any infections are present in the blood. 

Brain scans can also be done to look for possible brain injury, especially if there was an accident or some form of trauma leading up to the coma. 

♦ CT scans create a detailed x-ray of the brain to identify damage.
♦ MRI scans use radio waves and magnets to look at the brain.
♦ EEG measures the electrical activity of the brain.

The Glasgow Coma Scale is a neurological scale used to assign a rating to the patient’s consciousness for the initial assessment of a coma. Eye response, verbal response, and motor response are rated using a number, and a higher number in each category is the best possible response. The overall score will be between 3 and 15 with 3 being the worst and 15 being the best possible outcome. If scores in all 3 categories are 1, the prognosis is death.

Conditions Associated With Coma

Head injury: Damage or trauma to the brain can range from bruising to more traumatic injuries. Depending on the extent of the injury and severity of the damage, unconsciousness can last a long time.

Cardiogenic shock: This occurs when the heart has been damaged to a point where it can no longer pump blood efficiently. As a result, blood does not get to the brain as needed, which can result in a coma.

Dehydration: When your body loses more fluids then you are taking in, you are dehydrated. Severe dehydration can cause many complications to organs and their functions. Damage to the brain can lead to a coma.

Low blood sodium (hyponatremia): This occurs when your water and sodium levels are out of balance, and it causes muscle cramps and weakness. When sodium levels drop too low, rapid brain swelling can occur causing a coma and even death.

Low blood sugar (hypoglycemia): Low blood sugar levels can cause complications as our cells use glucose for energy. In diabetics, very low blood sugar levels can result in a diabetic coma, which can be life-threatening.

Intracerebral hemorrhage (ICH): This occurs when blood suddenly bursts into the brain tissues, which cause damage to the brain. Symptoms appear suddenly, and without intervention, the end result can be a coma.

Diabetic ketoacidosis: This is a serious complication of diabetes where ketone levels rise in the blood causing the acid level of the blood to increase. Without treatment and correction, you risk going into a diabetic coma.

Encephalitis: This inflammation of the brain tissue occurs as the result of a viral infection in the brain and spinal cord. This condition is rare and life-threatening, and a coma is a likely outcome. 

Maple syrup urine disease (MSUD): With this inherited disorder, the body is unable to process proteins, and as proteins are excreted through the urine, it has a distinct sweet odor. If treatment is not sought, the condition can result in seizures, a coma, and death.

Malaria: Malaria is caused by an infection that reaches the brain. Blood cells filled with the virus can swell and block blood flow to the brain. As a result, brain damage and coma can occur.

Treatment of a coma focuses on preserving brain function and life. Antibiotics are given immediately in the event an infection is present, and then medications will be given to treat any known underlying conditions. 

Surgery is only required if there is swelling in the brain. Once a coma patient is stabilized, a team of professionals monitor them closely and care for the patient to help prevent bedsores, infections, and contracture of muscles. They also make sure the patient is given nutrients while they are in the coma. 

Natural Treatment for Coma

A coma can occur as the result of several underlying conditions, such as low blood sugar (hypoglycemia) and encephalitis. Treatment typically focuses on preserving brain function regardless of the cause. In cases where a problem with the cardiovascular system is the cause, there are additional natural treatment options.

Blood glucose levels are important for energy and have a significant impact on the heart. High blood glucose can damage blood vessels over time, and low blood glucose can trigger a rapid heartbeat and dangerous palpitations.

The following ingredients can naturally regulate blood glucose to prevent the risk of a coma.

♦ Red yeast rice
Chromium

Coma from encephalitis results from damaged brain tissues as a result of chronic brain inflammation. Chronic inflammation can be triggered by conditions such as chronic hypertension and diseased blood vessels. Reduce inflammation naturally to protect blood vessels and brain tissues with the following ingredients:

Berberine bark extract is proven to reduce inflammation.
Capsicum extract is proven to enhance blood circulation, thus reducing the risk of coma.
Lion’s mane is a mushroom with clinically-proven anti-inflammatory benefits.

What Is the Long-Term Outlook?

Typically, comas last for no more than four weeks, but some can last for much longer. The length of the coma depends on the site of the damage and the severity. Some people come out of a coma with physical, psychological, and intellectual problems, and these are more pronounced the longer the individual remains in a coma. 

The best outlook for coma patients relies on seeking quick treatment, but ultimately the severity of the damage caused will dictate the outcome. 

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