[Coma from cerebral and metabolic causes].

The medical causes of coma fall into two main categories: intercranial diseases, and metabolic disturbances. The clinical examination should define 1) vital functions, 2) depth of coma, 3) whether cerebral signs are diffuse or local, 4) any signs of organ disease. The blood sugar level must be determined. Hypoglycemia may be the cause even if the signs point to another cause. Head injury and intoxication/poisoning must always be considered, even if a medical cause is suspected. Prolonged coma calls for repeated clinical and laboratory examination. Combinations of causes, e.g. organ disease plus intoxication should be considered.