Avoiding unnecessary trauma in the differential diagnosis of coma

Padkin, Andrew

doi:10.1046/j.1365-2044.1999.01198.x

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…Clinicians should not repeat stimuli to wake the patient. Anxiety is believed to be a contributing factor to psychogenic coma, so more noxious stimuli may cause greater anxiety in patients and delay recovery even more [ 13 ]. Anxiolytics, such as lorazepam, have been suggested for recovery [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Psychogenic coma after general anesthesia with remimazolam and remifentanil – a case report

Kim¹,

Kim²,

Lim³

et al. 2022

Korean J Anesthesiol

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Background Delayed emergence from general anesthesia is associated with life-threatening conditions with pharmacological, neurological, metabolic, and rarely, psychiatric causes. This case report was presented to report psychogenic coma after recovery from anesthesia with remimazolam and remifentanil. Case An elderly woman was unresponsive after recovery from anesthesia with remimazolam and remifentanil. Physical examination, laboratory testing, and radiographic imaging did not reveal any obvious organic causes. Pharmacological or metabolic abnormalities were not found. Absence of those causes strongly suggests that prolonged unconsciousness is related to psychiatric origin. The patient spontaneously regained consciousness after 48 h without any neurological complications. Conclusions Anesthesiologists should be aware of the possibility of psychogenic coma for patients with unexplained delay in emergence from anesthesia after the exclusion of other causes.

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Section: Discussionmentioning

confidence: 99%

Psychogenic coma after general anesthesia with remimazolam and remifentanil – a case report

Kim¹,

Kim²,

Lim³

et al. 2022

Korean J Anesthesiol

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“…The use of repeated painful or noxious stimuli is strongly contraindicated in psychogenic coma [11,12]. There may be severe psychological distress overwhelming the patient and it is important to remain sensitive in allowing the patient to gently recover.…”

Section: Discussionmentioning

confidence: 99%

Psychogenic Coma: Case Report

Baxter

White

2003

Int J Psychiatry Med

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Coma is present when the patient appears asleep, is unrousable, and unresponsive. Where no underlying medical condition is found, the role of the psychiatrist may become prominent. We present a clinical case and review the literature on psychogenic coma. According to DSM-IV-TR, psychogenic coma is a dissociative disorder not otherwise specified. Management is largely supportive. Principles include speaking in a reassuring manner and avoiding repeated painful stimuli. Education of family and other professionals that symptoms are real and not consciously feigned may be important. There may be a short-term role for anxiolytic and/or antipsychotic medication to assist return to consciousness.

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“…Using recurrent painful or mischievous stimuli is contraindicated in psychogenic coma [11,18]. There may be intense psychological grief crushing the patient.…”

Section: Use Of Repeated Painful or Noxious Stimulimentioning

confidence: 99%

Yasser’s Maneuver for Regaining the Consciousness in the Psychogenic Coma; A Novel Maneuver in Emergency Medicine and Psychiatry

Elsayed¹

2021

JCLR

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Introduction: Psychogenic coma, generally is one of the most anxious and irritant problems in clinical medicine for all medical practitioners. Using recurrent painful or mischievous stimuli is contraindicated in a psychogenic coma. Method of study and patients: My study was technical, prospective, observational, and interventional for 321 cases. The study was conducted in a physician outpatient clinic, Fraskour Central Hospital, and Ras-Al-bar Central Hospital. The author reported the 321 cases of psychogenic coma over nearly 5 years and 7-months, started from August 07, 2015, and, ended on March 07, 2021. Three selective groups were included in the study. Three groups were selected and evaluated for safety or complications and efficacy or responses. Suggesting hypothesis: Yasser’s maneuver can regaining the consciousness in a psychogenic coma. The research objectives to evaluate this hypothesis might include: What is psychogenic coma? What is Yasser’s maneuver? How can Yasser’s maneuver do improvement of psychogenic coma? Is the study supported by past publicized literature studies? Results: The range of age in the study was 16-55 years with an insignificant P-value (0.231). There is a female sex predominance for all groups (67%). The response for the group I was: (97.35%)) vs. (85.85%)) in group II, and (81.37%) in group III. The most common associated risk factor was psychogenic hyperventilation syndrome (HVS); in the group, I was 79.6%, in group II was 78.4%, and in group III was 96.2±1.7 with no statistical significance (P-value 0.74). Conclusions: The author concluded thatYasser’s maneuver is easy, available, quick, non-costive, time-saving, and extremely safe in the psychogenic coma. Very few and mild few mild complications for this maneuver encourage the generalizing use in the psychogenic coma.

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Avoiding unnecessary trauma in the differential diagnosis of coma

Cited by 3 publications

References 2 publications

Psychogenic coma after general anesthesia with remimazolam and remifentanil – a case report

Psychogenic coma after general anesthesia with remimazolam and remifentanil – a case report

Psychogenic Coma: Case Report

Yasser’s Maneuver for Regaining the Consciousness in the Psychogenic Coma; A Novel Maneuver in Emergency Medicine and Psychiatry

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