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Will Someone With Delta Waves Come Out Of Coma? Has Ischemia. Myoclonic, Facial Twitches, Tears.

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Posted on Mon, 11 Jun 2012
Question: Will someone with 1hz- 4hz come out of a coma. Was told also of ischemic?(lack of oxygen). Has slight myclonic, but when walk in room and talk to patient, hold hand they do calm down. Vent down to 5, bpm is anywhere from 22 up to 30. Does show signs of awareness ie...when talking to patient has facial twitches, tries to open eyes(opens to small slits). Pupils slow in reacting.Longest eyes open 48min. Occasionally has coughing spree. Would like to know of any treatments, medicines, to try and get brain more into a beta or alpha state. Do constantly talk to patient.
Patient goes from Beta Waves to XXXXXXX Waves. When certain physicians come in he gets spasmadic. Noticed when physicians talking in room abt taking off of vent(mind you was tested and withstood 1hr and 30min off). Went to patient and noticed a tear in corner of eye. To me that shows signs of awareness some where in brain. NEED some kind of information URGENTLY. Any help greatly appreciated.
doctor
Answered by Dr. Shiva Kumar R (7 hours later)
Hello,

Thanks for posting your query.

Severe lack of oxygen to the brain lowers / shuts down brain cell function. This is called as 'hypoxic ischemic encephalopathy'.

If someone has myoclonic jerks usually, but not always indicate more severe insult to the brain. However if someone opens eyes, has eye to contact and tearing it indicates that he is able to either see or hear you. Other reason for breaking down is probably underlying depression because of the current medical problem.

Personally, at this point of time I would put him on antidepressants along with Piracetam which can control the myoclonus to some extent. Discuss about these drugs with your neurologist. But overall I feel full recovery is difficult at this point of time.

The recovery progress of the condition can be monitored by repeat EEG. Extent of the damage to the brain can sometimes be made out by doing an MRI of the brain.

I agree that it would be difficult to perform an MRI when some one is on ventilator. You may discuss about these options with your neurologist too.

I understand that this is a very difficult time for you.

The bottom line is that I think you need to talk to neurologist and make sure the severity of the brain insult and the chances of recovery are discussed before starting the medications advised by me.

I hope you found my response to be helpful and informative. I will be available to answer follow up queries if any.

Regards

Above answer was peer-reviewed by : Dr. Jyoti Patil
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Answered by
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Dr. Shiva Kumar R

Neurologist

Practicing since :2001

Answered : 504 Questions

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Will Someone With Delta Waves Come Out Of Coma? Has Ischemia. Myoclonic, Facial Twitches, Tears.

Hello,

Thanks for posting your query.

Severe lack of oxygen to the brain lowers / shuts down brain cell function. This is called as 'hypoxic ischemic encephalopathy'.

If someone has myoclonic jerks usually, but not always indicate more severe insult to the brain. However if someone opens eyes, has eye to contact and tearing it indicates that he is able to either see or hear you. Other reason for breaking down is probably underlying depression because of the current medical problem.

Personally, at this point of time I would put him on antidepressants along with Piracetam which can control the myoclonus to some extent. Discuss about these drugs with your neurologist. But overall I feel full recovery is difficult at this point of time.

The recovery progress of the condition can be monitored by repeat EEG. Extent of the damage to the brain can sometimes be made out by doing an MRI of the brain.

I agree that it would be difficult to perform an MRI when some one is on ventilator. You may discuss about these options with your neurologist too.

I understand that this is a very difficult time for you.

The bottom line is that I think you need to talk to neurologist and make sure the severity of the brain insult and the chances of recovery are discussed before starting the medications advised by me.

I hope you found my response to be helpful and informative. I will be available to answer follow up queries if any.

Regards