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Coma is a symptom, not a diagnosis.
The aim of immediate management is to minimise any ongoing neurological damage whilst making a definitive diagnosis. Elements of the history, examination, investigation and treatment will therefore occur simultaneously.
Past history - seizures, diabetes, adrenal insufficiency, infection, cardiac, previous similar episodes (metabolic conditions).
In the presence of Consider Scalp bruising or haematoma Head injury Inconsistent history, retinal haemorrhage Non-accidental injury Fever, seizures Meningitis, Encephalitis Focal neurological signs Focal seizures Papilloedema Asymmetric pupils Focal intracerebral pathology, eg. Tumor Shunted hydrocephalus Blocked shunt Renal disease Hypertensive encephalopathy Consider NAI in any infant who presents with an unexplained encephalopathy.
Consider NAI in any infant who presents with an unexplained encephalopathy.
In the light of the possible diagnosis consider these investigations:
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