Coma

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Signs and Symptoms

All of the various states of unconsciousness are symptoms of severe neurological dysfunction. Coma can begin suddenly, such as when a person suffers a brain hemorrhage or severe head trauma, or can develop slowly over time. In a person who is intoxicated with alcohol or other drugs, for example, the early signs of an impending state of unconsciousness develop slowly. Usually the progression of the state of unconsciousness and how quickly it develops, provides clues about what is causing it.

In a slowly developing coma, patients may be only mildly confused and drowsy in the beginning, and/or their personality may change. If the underlying cause is an infection in the central nervous system, patients may feel a headache or other bodily discomfort, a fever, rash, muscular pains, or dizziness, before the actual coma develops. As time passes, they may begin to show signs of lethargy and obtundation, during which they are not quite unconscious but are not responding to external stimuli.

Sometimes a person who is falling into unconsciousness may not recognize what is happening and may not be able to complain. Or, it may happen so quickly that they don't have time to notice and complain.

After a person has entered into a state of unconsciousness, he or she may not respond to external stimuli, depending on how deep the coma is, and/or may show abnormal body movements. An unconscious person may lie still and not respond to anything, or may move spontaneously. These movements can include shaking, tremors, and jerking movements. The eyes may move abnormally. If the breathing muscles are affected, the patient's breathing may be irregular, and a respirator may be required.

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