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1

Coma – part 2

Coma like states

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2

Vegetative state

Awake but unresponsive state Respiratory and autonomic functions

retained “Awake coma“

Eyelids open Yawning, grunting, swallowing, limb and

head movements persist

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3

Vegetative state

Most common causes Cardiac arrest Head injuries

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4

Akinetic mutism

Partially or fully awake Immobile Unable to speak Can think Site of lesion

Medial thalamic nuclei or the frontal lobes Hydrocephalus

5

Abulia

Mild form of akinetic mutism Mental and physical slowness

Anatomical lesions Same as in akinetic mutism

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6

Catatonia

Major psychosis No brain damage

No voluntary or responsive movements Eyelid elevation

Actively resisted Blinking

Occurs in response to a visual threat

7

“ Waxy flexibility”

Catalepsy Limbs retain bizarre posture in which they

have been placed by the examiner

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