PEDIATRICS Vol. 65 No. 3 March 1980, pp. 477-483
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The Outcome of Prolonged Coma in Childhood

Lewis H. Margolis MD1 and Bennett A. Shaywitz MD1

1 Departments of Pediatrics and Neurology, Yale University Shool of Medicine, New Haven, Connecticut

The outcome of prolonged, nontraumatic coma (greater than five 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 one to five years after coma. Six children are normal, six have minor handicaps (attention deficit disorder, minor motor disorders, mild retardation, personality disorders), and four 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. Our results suggest that elevated intracranial pressure of greater than two days duration and deep coma of greater than two weeks were indicators of an abnormal outcome. In view of the improving technical capability to care for these children, but limited past experience, clearly defined defined and uniform criteria are needed both to assess children during coma and to evaluate them upon recovery.

Submitted on March 7, 1979
Accepted on June 18, 1979




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