Clinical evaluation of the unconscious patient

A systematic approach in the differential diagnosis of the comatose patient, based on the pathophysiological classification of the various disorders causing coma and the clinical neurological examination, is outlined. This approach appears useful in that in most instances a clinical diagnosis suggesting the pathophysiological abnormality producing coma can be made. Appropriate laboratory tests can then be selected to establish a definitive etiological diagnosis. Such a systematic approach to the evaluation of the comatose patient hastens definitive therapy in a disorder where time in which to institute therapy is often short.