The Neurological Exam of a Comatose Patient: An Essential Practical Guide

Malays J Med Sci. 2020 Oct;27(5):108-123. doi: 10.21315/mjms2020.27.5.11. Epub 2020 Oct 27.

Abstract

A thorough examination of a comatose patient is essential given the spectrum of clinical diagnoses. The most immediate threat to patients is airway, breathing and circulation. All attending physician should employ a structured and focused approach in dealing with a comatose patient. It is important to recognise the urgent steps needed at the time to prevent further deterioration, followed by the final diagnosis of patient's neurologic status. Here we provide the essential practical guide to the neurological exam of a comatose patient that would assist to determine the aetiology, location and nature of the neurological lesion.

Keywords: comatose; consciousness; cranial nerves; meningism; motor assessment.