Disorders of consciousness (coma, vegetative, locked-in)

Overview

Coma is unresponsive with eyes closed. Vegetative state has sleep-wake cycles without awareness. Locked-in means aware but unable to move most muscles.

Some people recover over time; teams help families understand prognosis.

Symptoms

Common signs:

• Not awake or aware

Less common

• Eyes open without awareness

Look up a symptom: New confusion or not acting like themselves

When to get medical care

Causes

Brain injury.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Diagnosis

A clinician asks about your symptoms and may order tests.

The exam

A physical exam.

Tests

Tests, if needed:

• MRI:
• EEG:

Treatment

Treatment depends on the cause and how severe it is.

Self-care

• Talk to the person and play music

Prevention

To lower your risk or prevent problems:

• Helmets
• Seat belts

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a neurologist (brain and nerve doctor).

Living with it

Support groups and helplines

• Genetic and Rare Diseases Information Center (GARD): Free NIH information on rare diseases, including where to find experts and patient groups.
• National Organization for Rare Disorders (NORD): Patient groups, help finding care, and aid programs for rare diseases.

Children, pregnancy, and older adults

• Families: Social workers and palliative care can support decisions.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

Outlook

Outlook depends on the cause; early care helps.

Getting ready for your visit

Bring a list of your symptoms and medicines.

What to bring

• A list of your medicines and supplements
• Notes on when symptoms started and what makes them better or worse

Questions to ask

• What's causing this?
• What treatment do you recommend?
• What are the chances of recovery?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Disorders of consciousness (coma, vegetative, locked-in)