Spontaneous eye movements Roving eye movements are slow, conjugate, lateral, to and fro excursions. These occur when third nerve nuclei and connections are intact and often indicate a toxic, metabolic or alternatively bilateral hemisphere cause for coma.
Roving eye movements are the sign of cortical dysfunction not involving the brainstem. This finding is useful in the differential diagnosis of impaired consciousness and indicates cerebral damage in patients with hypoglycemic coma.
Our eyes are constantly moving, and while some of those movements are under conscious control, many of them occur subconsciously.
A patient in a coma will have no conscious response to external stimuli and may appear to be in a deep sleep. The patient in a coma may exhibit spontaneous body movements. Patients may shake or jerk abnormally, and their eyes may move. If the coma is severe, even basic body functions such as breathing may be affected.
People in a state of coma are alive but are unable to move or be aware of or respond to their surroundings. They lose their thinking abilities but retain non-cognitive function and normal sleep patterns. A person may appear fine, but will not able to speak or respond to commands.
The eyes may open in response to stimuli. The person is able to move their body. Heart rate, blood pressure and respiration continue.
Most people do come out of a coma
In some rare cases, a person might stay in a coma for several weeks, months or even years. Depending on what caused the person to go into a coma, some patients are able to return to their normal lives after leaving the hospital.
Some examples of early responses to watch for are: Localized response: These are appropriate movements by the patient in response to sound, touch, or sight. Turning toward a sound, pulling away from something uncomfortable, or following movement with the eyes are examples.
Patients in coma show continuous absence of eye opening and any spontaneous or stimulus induced arousal or voluntary behavioural responses. Hence, they are neither awake nor aware.
Someone who is in a coma is unconscious and has minimal brain activity. They're alive but can't be woken up and show no signs of awareness. The person's eyes will be closed and they'll appear to be unresponsive to their environment.
As many as 15 to 20 percent of patients who appear to be in a coma or other unresponsive state show these inner signs of awareness when evaluated with advanced brain-imaging methods or sophisticated monitoring of electrical activity.
passive eyelid opening results in pupillary constriction, whereas if the patient is sleeping or comatose (with intact pupillary reflexes) the pupils dilate on passive eyelid opening.
If and when the person becomes unconscious they may not be able to respond to you, however, they will still be aware of your presence and voices around them. Studies indicate that hearing is the last of the senses to be lost.
Some patients awaken from coma (that is, open the eyes) but remain unresponsive (that is, only showing reflex movements without response to command). This syndrome has been coined vegetative state.
The person's eyes will be closed and they'll appear to be unresponsive to their environment. They won't normally respond to sound or pain, or be able to communicate or move voluntarily. Someone in a coma will also have very reduced basic reflexes such as coughing and swallowing.
Severe brain injury is usually defined as being a condition where the patient has been in an unconscious state for 6 hours or more, or a post-traumatic amnesia of 24 hours or more. These patients are likely to be hospitalised and receive rehabilitation once the acute phase has passed.
Duration of coma
The longer a patient remains in a coma the poorer his or her chance of recovery and the greater the chance that he or she will enter a vegetative state (table 3). By the third day the chance of making a moderate or good recovery is reduced to only 7%, and by the 14th day is as low as 2%.
Can Your Loved One Hear You? During a coma, the individual is unconscious, meaning they are unable to respond to any sounds. However, the brain may still be able to pick up on sounds from loved ones. In fact, some studies suggest talking and touching a loved one while they are in a coma may help them recover.
A coma doesn't usually last longer than several weeks. People who are unconscious for a longer time might transition to a lasting vegetative state, known as a persistent vegetative state, or brain death.
Speaking may not affect their clinical outcome; time spent with them takes time away from other, more "viable" patients. Comatose patients may, however, hear; many have normal brain-stem auditory evoked responses and normal physiologic responses to auditory stimuli.
"Being in a coma is like a magnified and intense version of our own dreams," she said. "Everything that happens in the real world, you hear, you're aware of, you kind of know what's going on, but it goes through this weird filter thing in your brain."
In brain dead cases, the spirit or soul is usually out of the body, though often the brain dead person's spirit stays with the body until life support is switched off.