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Childhood non-traumatic coma in Kuala Lumpur, Malaysia

A Sofiah1, I H Hussain

  • 1Neurology Unit, Kuala Lumpur Hospital, Malaysia.

Annals of Tropical Paediatrics
|May 14, 1998
PubMed

Insights

Infection is the leading cause of non-traumatic coma in children, with outcomes significantly worse in this group. This contrasts with Western data, highlighting regional differences in childhood coma aetiology.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Acute non-traumatic coma is a critical condition in children with varied causes and outcomes.
  • Understanding the aetiology of childhood coma is crucial for effective management and prognosis.
  • Existing data on childhood coma aetiology shows considerable variation, particularly between Eastern and Western populations.

Purpose of the Study:

  • To determine the aetiology and outcomes of acute non-traumatic coma in post-neonatal children.
  • To compare findings with existing international data on childhood coma.

Main Methods:

  • Prospective analysis of 116 post-neonatal children admitted with acute non-traumatic coma over an 8-month period.
  • Follow-up of patients for 18-24 months to assess outcomes.
  • Categorization of coma aetiology into infection, toxic metabolic, hypoxic-ischaemic insults, intracranial haemorrhage, and miscellaneous causes.

Main Results:

  • Infection was the predominant cause (69%), followed by toxic metabolic (13%) and hypoxic-ischaemic insults (5%).
  • Mortality was high (35.7%), with 29.3% experiencing permanent neurological deficits.
  • Outcomes were significantly worse in children with infectious aetiologies; findings align with Japanese data but differ from Western studies.

Conclusions:

  • Infectious causes are the primary driver of non-traumatic coma in this pediatric cohort.
  • The high incidence of infection-related coma and associated poor outcomes necessitate targeted preventive and therapeutic strategies.
  • Regional variations in the aetiology of childhood coma underscore the importance of localized epidemiological data.

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