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Coma Scales. The primary goal of the neurologic examination in an unresponsive patient is to localize the lesion and thereby narrow the differential diagnosis. The examination should proceed in a stepwise fashion and be familiar to the neurologist because of constant repetition.
In caring for the seizure patient in the emergency department (ED), 3 basic pitfalls must be avoided. The first is failure to recognize seizure activity. Nonconvulsive seizure is a rare presentation of altered mental status (AMS) but should always be on the differential of the comatose patient.