Related Experiment Videos
Persistent but reversible coma in encephalitis.
Masao Nagayama1, Kazushi Matsushima, Tomiko Nagayama
1Department of Neurology,Tokai University School of Medicine, Kanagawa 259-1193, Japan. nagay001@is.icc.u-tokai.ac.jp
Neurocritical Care
|September 15, 2005
Summary
Persistent but reversible nontraumatic coma, often linked to viral encephalitis, can lead to late recovery of consciousness and function in adults. This study highlights the importance of recognizing this rare clinical spectrum.
Area of Science:
- Neurology
- Critical Care Medicine
- Infectious Diseases
Background:
- Nontraumatic coma in adults typically has a poor prognosis with limited chances for late recovery.
- While functional recovery is usually minimal, rare cases of late recovery in awareness and function exist.
Purpose of the Study:
- To identify and evaluate the clinical spectrum of patients experiencing persistent but reversible nontraumatic coma.
- To understand the characteristics and outcomes of individuals with prolonged nontraumatic coma who eventually recover.
Main Methods:
- Retrospective review of inpatient medical records from the 1990s.
- Inclusion criteria: deep coma (Glasgow Coma Scale ≤7), nontraumatic cause, coma duration >1 month, and subsequent normal GCS recovery.
- Evaluation of the clinical spectrum of identified patients.
Main Results:
- Six patients (ages 16-75) met the criteria for persistent, reversible nontraumatic coma.
- Viral encephalitis was the diagnosis in five patients (HSV, CMV, EBV/CMV).
- Two young female patients experienced protracted comas lasting 3 and 18 months; complications included nonconvulsive status epilepticus and medication overdose.
Conclusions:
- Persistent but reversible nontraumatic coma is a distinct clinical entity.
- Viral encephalitis is a significant cause of this condition.
- Recognizing this spectrum is crucial for appropriate patient management and prognosis.