COMA-METABOLIC ETIOLOGY

SUMMARY

1. Causes: ischemia, hypoxia, hypoglycemia, thiamine deficiency (Wernicke's encephalopathy), organ disease (lung, liver, kidney), and drugs.

2. Early in metabolic encephalopathy, patients have changes in respiratory pattern and mentation.

3. The pupils are typically reactive until the terminal stages.

4. Exceptions include anticholinergic toxicity, which causes fixed dilated pupils, and severe barbiturate intoxication.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].