coma with eyes open
Introduction
Introduction Blinking into a coma is manifested by the patient's clear mind, but in addition to the movement of the eyeball, the other can not move, can follow the instructions to close the eye or do eye movement in all directions.
Cause
Cause
Blinking coma can be caused by a variety of causes: among them, drug poisoning, CO poisoning, alcoholism, severe craniocerebral trauma, cerebrovascular disease, encephalitis, brain fat embolism, spontaneous sputum, drowning and other severe hypoxic ischemic encephalopathy.
Examine
an examination
Related inspection
Corneal reflex examination shallow reflex examination pupillary reflex brain CT examination
1 Loss of cognitive function, unconscious activity, unable to execute instructions.
2 Maintain spontaneous breathing and blood pressure.
3 have a sleep-wake cycle.
4 can not understand and express language.
5 can automatically blink or stimulate the lower eye.
6 can have a purposeless eye tracking movement.
7 hypothalamic function and brainstem function are basically preserved.
Diagnosis
Differential diagnosis
Blink coma should be differentiated from coma, atresia syndrome, functional non-responsiveness, and brain death. A comatose patient has no sleep-wake cycle and does not blink or stimulate the lower eye. The atresia syndrome is seen in the basal part of the pons. Although the patient can't turn to the sides and can't talk, but the consciousness is still clear, can understand the question, and express the mental activity and the plant with vertical eye movement and blinking. The state looks awake and the unconscious content is different.
The functional non-responsive state is a state of mental depression caused by mental factors that does not respond to external environmental stimuli. The patient has an emotional reaction (such as tears in the corners of the eyes) and active resistance. When the eyes are opened, the eyes are closed more tightly. The key to distinguishing from brain death is whether brain stem reflex exists. Patients with persistent vegetative state can spontaneously blink and rotate the eyeball. The pupil has light reflection and corneal reflex, and there are chewing, swallowing and other reflections. Brain stem remnants disappear completely.
1 Loss of cognitive function, unconscious activity, unable to execute instructions.
2 Maintain spontaneous breathing and blood pressure.
3 have a sleep-wake cycle.
4 can not understand and express language.
5 can automatically blink or stimulate the lower eye.
6 can have a purposeless eye tracking movement.
7 hypothalamic function and brainstem function are basically preserved.
