Coma in children or in general (even for adults) is an unconscious state of mind, where a person doesn’t respond to the external environment. In a coma, the person is alive and the brain is functioning, but at its least state of alertness.
The state of coma can lasts longer than more than a few weeks. Children who remain in an unconscious state of coma for a very long period of time could go into a persistent vegetative state.
There are several causes of coma, the majority of them being similar for children as well as adults. Now, people who are in this persistent vegetative state of coma might awaken or no – highly depends on its cause.
Symptoms of Coma in Children
The signs and symptoms of pediatric coma may include:
- The child appears to be in deep sleep
- In a coma, the child’s breathing becomes unusual
- When in a coma, the child may be holding his/her body in an unusual posture
- The child’s limbs or pupils show no responses, except for reflexive movements
- In a state of coma, the child’s body doesn’t even respond to pain, except for reflexive movement
- The child in a coma may show impulsive body movements including abnormal jerks
- In a coma, the child’s eyes would be affected. For instance, one pupil would be larger than the other or both are restricted
- No muscle strength or voluntary movements
Causes of Coma in Children
There are several factors which may cause a child or an adult to get into the coma state. From head injury, stroke to even a basic illness like metanolic diseases or infection can lead a child into coma.
Let’s read some of the major and highly known causes of pediatric coma:
Stroke
Stroke is a result of reduced or disturbed supply of blood to the brain which might happen due to blockage of arteries or a burst blood vessel. This stroke event may get a person into a state of coma.
Lack of Oxygen
Oxygen is necessary for brain cells to function smoothly. A person who’s suffered from a heart attack or a child who is rescued from drowning might not awaken or may get into coma due to lack of oxygen to the brain.
Toxins
When the body is exposed to dangerous toxins like carbon monoxide or lead, it can result in brain damage, ultimately leading to coma.
Tumours and Injuries in the Brain
Tumours and injuries in the brainstem or in the brain can be a cause of coma in children.
Intracranial Bleeding
The collection of blood within the skull.
Physical Exams and Laboratory Tests
As a part of the coma treatment, the doctors would first conduct a physical examination of the patient. Doctors would use the Glasgow Coma Scale (GCS) where they grade the:
- Eye Response
- Verbal Response
- Movement Response
Through this and Neurologic Examination doctors can know the cause of the coma and location of brain damage.
As a part of their coma treatment, doctors would see their breathing pattern, and observe their skin for symptoms of any contusions due to the stroke or trauma.
A couple of laboratory tests would be conducted and blood samples would be taken to check:
- Total blood count
- Poisoning due to carbon monoxide
- Electrolytes, glucose, thyroid, kidney and liver functioning
There are certain brains scans performed as well as a process of coma treatment:
- Computerised tomography (CT) scan
- Magnetic resonance imaging (MRI)
- Electroencephalography (EEG)
Treatment for Coma in Children
Coma being a medical emergency, the very first important thing which doctors would do is check the patient’s breathing and get their respiration and circulation in place. They may provide the patient with immediate breathing assistance, medications for the brain, and various other support that would help the coma patient and his/her family.
Coma treatment is highly dependent on the cause of coma. Probably, a brain pressure release technique or medication might be needed.
The treatment of coma caused due to drug overdose would be different than a coma caused due to toxins. The doctors may advise medications and therapies to treat a fundamental disease as well, such as diabetes or liver problems.
At times, the detected causes of coma can be totally reversed and the child or adult can be revived into his normal life. But if the brain damage is severe, getting the kid or adult out of the coma is very difficult. They may have to live with a permanent disability or never regain consciousness from a coma. They may remain in a persistent vegetative state or suffer brain death.
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