[Functional coma: case report and systematic review].

Area of Science:

• Neurology
• Psychiatry
• Psychosomatic Medicine

Background:

• Functional coma is an exceedingly rare disorder, with only 21 cases documented in medical literature.
• It is strongly associated with conversion disorder or dissociative disorder, predominantly observed in female patients.
• Identified predisposing factors include a history of abuse, psychiatric conditions, prior functional coma episodes, and recent general anesthesia.

Observation:

• Clinical signs suggestive of functional coma lack sufficient sensitivity and specificity for definitive diagnosis.
• Diagnosis is established through exclusion, requiring normal vital signs, routine blood work, electroencephalogram, and central nervous system imaging.
• Key differential diagnoses include catatonia, factitious disorder, and malingering.

Findings:

• Functional coma is characterized by a state resembling coma but without underlying organic pathology.
• The disorder is linked to psychological distress manifesting as a neurological deficit.
• Spontaneous recovery is the typical course, occurring within approximately 45 minutes to 4 days.

Implications:

• Highlights the importance of considering psychogenic disorders in unexplained coma-like states.
• Emphasizes the need for a thorough differential diagnosis process, ruling out organic causes.
• Suggests that prompt recognition and appropriate psychiatric evaluation can lead to favorable outcomes and recovery.