Toxin-induced comas are caused by extrinsic substances, whereas metabolic-induced comas are caused by intrinsic processes, such as body thermoregulation or ionic imbalances(e.g. sodium). For instance, severe hypoglycemia (low blood sugar) or hypercapnia (increased carbon dioxide levels in the blood) are examples of a metabolic diffuse neuronal dysfunction. Hypoglycemia or hypercapnia initially cause mild agitation and confusion, but progress to obtundation, stupor, and finally, complete unconsciousness. In contrast, coma resulting from a severe traumatic brain injury or subarachnoid hemorrhage can be instantaneous. The mode of onset may therefore be indicative of the underlying cause.Structural and diffuse causes of coma are not isolated from one another, as one can lead to the other in some situations. For instance, coma induced by a diffuse metabolic process, such as hypoglycemia, can result in a structural coma if it is not resolved. Another example is if cerebral edema, a diffuse dysfunction, leads to ischemia of the brainstem, a structural issue, due to the blockage of the circulation in the brain. Diagnosis
Although diagnosis of coma is simple, investigating the underlying cause of onset can be rather challenging. As such, after gaining stabilization of the patients airways, breathing and circulation (the basic ABCs) various diagnostic tests, such as physical examinations and imaging tools (CT scan, MRI, etc.) are employed to access the underlying cause of the coma.When an unconscious person enters a hospital, the hospital utilizes a series of diagnostic steps to identify the cause of unconsciousness.
The spinocerebellar tract is a nerve tract originating in the spinal cord and terminating in the same side (ipsilateral) of the cerebellum. Origins of proprioceptive information
Proprioceptive information is obtained by Golgi tendon organs and muscle spindles. Golgi tendon organs consist of a fibrous capsule enclosing tendon fascicles and bare nerve endings that respond to tension in the tendon by causing action potentials in type Ib afferents. These fibers are relatively large, myelinated, and quickly conducting. Muscle spindles monitor the length within muscles and send information via faster Ia afferents. These axons are larger and faster than type Ib (from both nuclear bag fibers and nuclear chain fibers) and type II afferents (solely from nuclear chain fibers).All of these neurons are sensory (first order, or primary) and have their cell bodies in the dorsal root ganglia. They pass through Rexed laminae layers I-VI of the posterior grey column (dorsal horn) to form synapses with second order or secondary neurons in layer VII just beneath the dorsal horn. Subdivisions of the tract
The tract is divided into:

Dorsal spinocerebellar tract
The dorsal spinocerebellar tract (posterior spinocerebellar tract, Flechsigs fasciculus, Flechsigs tract) conveys proprioceptive information from proprioceptors in the skeletal muscles and joints to the cerebellum.It is part of the somatosensory system and runs in parallel with the ventral spinocerebellar tract. It carries proprioceptive information from muscle spindles and Golgi tendon organs of ipsilateral part of trunk and lower limb. Proprioceptive information is taken to the spinal cord via central processes of dorsal root ganglia (first order neurons).