1. Alteration of Consciousness

2. Reticular activating system (RAS)

17. COMA

19. Glasgow Coma Scale : Eye opening (E)

20. Glasgow Coma Scale : Motor response (M)

21. Glasgow Coma Scale : Verbal response (V)

26. Decorticate posture results from damage to one or both corticospinal tracts

27. Decerebrate posture results from damage to the upper brain stem

31. Doll’s eye maneuver (Oculocephalic reflex) Cold caloric test (Oculovestibular reflex)

33. Eye movements Condition Awake Cerebral dysfunction, brainstem intact Brain stem lesion Doll’s eyes Negative Positive Negative Condition Awake Cerebral dysfunction, brainstem intact Brain stem lesion Cold calorics Nystagmus, N/V, pain Slow deviation toward water Negative

34. Respiratory patterns

40. COMA LOCALIZING SIGN NO LOCALIZING SIGN SUPRATENTORIAL INFRATENTORIAL NO STIFF NECK STIFF NECK - CVD - TUMOUR - ABSCESS STRU C TURAL DAMAGE FUNCTIONAL NEURONAL DEPRESSION - HYPOXIA - CARDIAC ARREST - ENCEPHALITIS - HEPATIC - URAEMIC - POST ICTAL STATE - FLUID ELECTROLYTE IMBALANCE - DRUGS - SAH - MENINGITIS