To propose a structured diagnostic algorithm for evaluating and managing coma of unknown origin, with a focus on identifying reversible causes.
Key Findings:
A structured diagnostic approach is essential for effective management of coma.
EEG and neuroimaging play critical roles in the evaluation process.
Regular reassessment is necessary to adapt to the evolving clinical situation.
Emerging technologies may significantly transform coma management.
Interpretation:
The proposed framework aims to shift the focus from merely identifying clinical syndromes to early characterization of targetable coma endotypes based on measurable traits.
Limitations:
The review excludes coma related to major traumatic brain injury, hypoxic brain injury, and large-vessel ischemic strokes, which may limit the applicability of the proposed approach.
The approach may require multidisciplinary collaboration, which can be challenging in acute settings.
Conclusion:
The systematic approach to diagnosing and managing coma of unknown origin emphasizes the importance of early identification of reversible causes and the integration of emerging technologies.
by Stein Silva, Miriam Treggiari, Giuseppe Citerio, Robert David Stevens, Marzia De Lucia, Virginia Newcombe, Aurore Thibaut, Nicolas Weiss, Romain Sonneville
