Abstract

COMA: CURRENT AND EMERGING TREATMENT OPTIONS

R. Sudheer Babu*, K. S. Lakshmi Bhargavi, Sd. Rihana, K. Swathi Sri, K. Durga Prasad and Hankila Ayimchunger

Abstract

Coma means unarousable, unresponsiveness whereby a patient cannot react with the surrounding environment. It is a state of unconsciousness where by a patient cannot make no localizing responses or discrete defensive movements. Principle causes of coma are diffuse brain dysfunction, drug over dose, alcohol abuse, copoisoning, hypoxic/ischemic brain injury. Neuronal network in the dorsal Pons and mid brain gives rise to ascending reticular activating system (ARAS) which is responsible for arousal. The CT scan may provide information about the cause of altered mental status and the presence of intracranial hypertension and lumbar puncture (LP) include making an early diagnosis of CNS infection and identification of pathogen, drug sensitivity. Treatment strategies include immediate assessment of airway, breathing, circulation resuscitate, monitoring pulse oximetry. Immediate therapy for hypoglycemia includes giving 50ml glucose IV. Broad spectrum antibiotics, antiviral should be given empirically if there is any suggestion of bacterial infection or encephalitis. Mannitol is indicated acutely for patients who have raised ICP/imminent herniation anti-seizure medications used to treat convulsions in comatose patients. Iron chelation therapy for children with deep coma in cerebral malaria. Methyl phenidate and amantadine used to stimulate reawakening in comatose patients resuscitated from cardiac arrest and in patients with traumatic brain injury. Miraculous recovery from coma by zolpidem. Miraculous herb known as selaginella bryopteris is believed to have unbelievable medicinal value of reviving one from death in coma.

Keywords: Mrita sanjeevani, zolpidem miraculous action in coma, iron chelation therapy, coma in pregnant women, seizures during coma, diabetic coma, myxedema coma.