تسجيل الدخول

تسجيل

Applications , Differential diagnosis of coma

المؤلف:  Sue Jickells , Adam Negrusz (Editors)

المصدر:  Clarkes Analytical Forensic Toxicology

الجزء والصفحة:  222

2026-10-15

490

Applications

Differential diagnosis of coma

When circumstantial evidence is lacking, a diagnosis of poisoning may be difficult to sustain simply on the basis of clinical examination, since coma induced by drugs is not readily differentiated from that caused by disease processes. Apparent poisonings can be caused by hypo glycaemic coma, a cerebrovascular accident, exhaustion (after seizures), brain damage, meningitis, withdrawal symptoms, idiosyncratic reactions (e.g. to theophylline and caffeine), allergic reactions (shock), viral infections or unexpected symptoms of a disease (e.g. Lyme disease). In these situations, toxicological analyses serve either to confirm poisoning as the cause of coma or to rule it out in favour of an organic disorder that requires alternative medical and pathological investigations. A particular, but not uncommon, poisoning is water intoxication, which only can be determined indirectly by sodium serum concentration or osmolarity.