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Related Experiment Videos

Non traumatic coma.

Arun Bansal1, Sunit C Singhi, Pratibha D Singhi

  • 1Department of Pediatrics, Advanced Pediatrics Center, Post Graduate Institute of Medical Education and Research Center, Chandigarh, India.

Indian Journal of Pediatrics
|June 30, 2005
PubMed
Summary
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Central nervous system (CNS) infections are the leading cause of non-traumatic coma in children. Simple clinical signs at admission and 48 hours predict patient outcomes, guiding prognosis for pediatric non-traumatic coma.

Area of Science:

  • Pediatric Neurology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Non-traumatic coma in children presents a significant diagnostic and prognostic challenge.
  • Understanding the common etiologies and identifying predictive clinical signs are crucial for effective management.

Purpose of the Study:

  • To investigate the causes and clinical characteristics of non-traumatic coma in pediatric patients.
  • To identify clinical indicators that predict the outcome of non-traumatic coma in children.

Main Methods:

  • A study of 100 children (2 months to 12 years) with non-traumatic coma.
  • Clinical signs, including Glasgow Coma Scale (GCS), respiratory patterns, pupillary reflexes, and motor responses, were assessed at admission and 48 hours.
  • Etiology was determined through clinical evaluation and investigations; outcomes were categorized as survival with varying degrees of disability or death. Statistical analyses included chi-square tests and logistic regression.

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Main Results:

  • Central nervous system (CNS) infections were the most frequent cause (60%), followed by toxic-metabolic conditions (19%).
  • Survival rates were higher for CNS infections compared to toxic-metabolic causes or intracranial bleeds (P < 0.05).
  • Predictors of mortality included young age (<3 years), poor pulse volume, abnormal respiratory patterns, absent pupillary and extraocular movements, and papilledema.

Conclusions:

  • Central nervous system infections are the primary cause of non-traumatic coma in children.
  • Basic clinical signs assessed on admission and after 48 hours serve as reliable predictors of outcome in pediatric non-traumatic coma.