The following symptoms and complaints may indicate Somnolence, Sopor and Coma (disorders of consciousness):
Leading symptoms of somnolence
- Drowsiness, which, however, can be briefly broken by external stimuli
- Orientation is always possible
- Simple questions can be answered
Guiding symptoms of the sopor
- Drowsiness to be broken by very strong external stimuli.
- Contact not adequately possible
- “Short-term orientation effort” with external stimuli
- No spontaneous activity possible
Leading symptoms of coma
- Deep unconsciousness associated with a lack of any response to external stimuli (unable to awaken).
Four stages of coma can be differentiated:
Stage | Description |
I | Brief, specific defense to pain stimuli, no pupillary dysfunction |
II | Defensive movements untargeted, mostly positive light reaction |
III | No defensive movements, vestibulo-ocular reflex (VOR) pathological (i.e., stable visual perception is no longer possible with sudden head movement), flexion synergisms (abnormal flexion) |
IV | Stretching synergisms (abnormal stretching) may occur, otherwise no motor response, pupils fixed to light, brainstem reflexes drop out |