The Outcome of Prolonged Coma in Childhood

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Abstract
The outcome of prolonged, nontraumatic coma (> 5 days) in 16 children is reviewed to determine operational clinical parameters which may assist in both clinical decision making and counseling of parents. The children were evaluated by physical and neurologic examinations and school reports 1-5 yr after coma. Six children are normal, 6 have minor handicaps (attention deficit disorder, minor motor disorders, mild retardation, personality disorders) and 4 have sustained major sequelae (severe retardation, uncontrolled seizures, blindness). Anoxia, as an etiology of coma and the need for assisted ventilation, were significant indicators of a less than normal outcome. Elevated intracranial pressure of > 2 days duration and deep coma of > 2 wk were possible indicators of an abnormal outcome. In view of the improving technical capability to care for these children, but limited past exerience, clearly defined and uniform criteria are needed both to assess children during coma and to evaluate them upon recovery.