Psychogenic Coma: Case Report

  title={Psychogenic Coma: Case Report},
  author={Cynthia L Baxter and William D White},
  journal={The International Journal of Psychiatry in Medicine},
  pages={317 - 322}
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… Expand
Psychogenic unresponsiveness.
Unresponsive patients with or without catatonic motor signs are etiologically heterogeneous, and all require a comprehensive neurodiagnostic assessment to rule out organic causes. Most cases prove toExpand
Catatonic coma with profound bradycardia.
The authors argue that the descriptive term "catatonic coma" is preferable over terms implying psychogenesis, such as "psychogenic" or "hysterical" coma; for catatonia, the authors have a specific treatment, in the form of benzodiazepines; for "psychogenesis," there is none. Expand
Functional Coma: Two Case Reports and a Review of the Literature.
Functional coma should be conceptualized as a distinct condition from catatonia and psychogenic non-epileptic seizures, and should supplant the previous phrase of "psychogenic coma". Expand
Functional coma.
A wide range of terms used to describe states of unresponsiveness in which psychologic factors are relevant to etiology are examined, such as depressive stupor, catatonia, nonepileptic "pseudostatus," and factitious disorders, and the place of functional or psychogenic coma among these are discussed. Expand
Repeated episodes of difficulty with arousal following general anesthesia in a patient with ulnar neuropathy
An otherwise healthy and mentally sound 52-year-old woman is described who experienced repeated dissociative episodes following general anesthesia for minor surgical procedures and resulted in admission to the intensive care unit. Expand
A Clinically Oriented Perspective on Psychogenic Nonepileptic Seizure–Related Emergencies
Increased awareness of PNES is necessary to prevent iatrogenic harm and to identify underlying psychiatric illnesses that carry their own risks, and data available to guide treatment are scant, and further study is needed. Expand
Dissociative disorders causing unconsciousness and collapse during oral surgery treatment
A 51-year-old female referred to the clinic for the removal of the inflamed implant in the anterior left side of the maxilla showed a collapse and an excretion of bubbly saliva form her mouth during the treatment and was diagnosed dissociative disorder. Expand
Initial Diagnosis and Management of Coma.
The general emergency department approach begins with stabilization of airway, breathing, and circulation, followed by a thorough physical examination to generate a limited differential diagnosis that is then refined by focused testing. Expand
Deficit neurologici non organici
Si definiscono psicogeni i deficit che non possono essere attribuiti ad alterazioni strutturali o a malattie neurochimiche note, ma che possono essere provocati da malattie psichiatriche o daExpand
Le pseudo-coma hystérique : à propos d’un cas clinique
Resume Le pseudo-coma hysterique est un etat qui peut durer plusieurs heures, voire plusieurs jours, et qui correspond a un etat de sommeil clinique contrastant avec un etat de veilleExpand


Pseudoneurologic syndromes: recognition and diagnosis.
Patients with a collection of psychologic disorders that present with neurologic symptoms or signs, yet have no identifiable structural or functional etiology within the nervous system, require compassionate and understanding care to resolve underlying emotional problems. Expand
Psychogenic coma after use of general anesthesia for ethmoidectomy.
A 49-year-old woman with a history of depression, who did not awaken promptly after use of general anesthesia for ethmoidectomy, is described, and it is hypothesized that she underwent a transient, self-limited period of dissociation related to unresolved grief due to the recent death of a family member. Expand
Recurrent psychogenic coma following tracheal stenosis repair.
It is hypothesized that the patient's apparent comas were the result of an underlying conversion disorder precipitated by unresolved psychological conflict surrounding a long history of abuse in which she was repeatedly smothered by a pillow. Expand
Hysteria. A cause of failure to recover after anaesthesia.
A young, healthy 22-year-old female suffering severe dental phobia who was undergoing dental conservation is described, and hysteria as a cause of failure to recover consciousness following general anaesthesia is described. Expand
Faking unconsciousness
The implication that the care provided to critically ill medical ITU patients by anaesthetic trainees may not be optimal does grave injustice to the many dedicated consultant anaesthetists and excellent nurses who are involved in managing these challenging patients. Expand
Deviation of the eyes towards the ground with the patient lying on each side is proposed as a diagnostic sign in psychogenically mediated states resembling coma or epilepsy. Six cases are describedExpand
An unusual case of hysterical postoperative coma
From ASA Meeting: The intubating laryngeal mask; results of a multicentre trial with experience of 500 cases. Expand
Avoiding unnecessary trauma in the differential diagnosis of coma
With reference to the letters in the July issue, I should like to express my support for the views of Dr Cartwright concerning dental anaesthesia, and suggest that 90% of the patients I had been anaesthetising could have been managed without a general anaesthetic. Expand
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