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A coma is a "profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem reticular formation."[1]

Unlike in coma, the eyes may be open in the persistent vegetative state.[2]

The FOUR (Full Outline of UnResponsiveness) score may be better than the Glasgow Coma Scale (GCS) among patients in critical care.[3] The FOUR Score tests:

  • eye response
  • motor response
  • brainstem reflexes
  • respiration pattern


  1. Anonymous (2023), Coma (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Ropper AH (2010). "Cogito ergo sum by MRI.". N Engl J Med 362 (7): 648-9. DOI:10.1056/NEJMe0909667. PMID 20130248. Research Blogging.
  3. Iyer VN, Mandrekar JN, Danielson RD, Zubkov AY, Elmer JL, Wijdicks EF (2009). "Validity of the FOUR score coma scale in the medical intensive care unit.". Mayo Clin Proc 84 (8): 694-701. DOI:10.4065/84.8.694. PMID 19648386. PMC PMC2719522. Research Blogging.