Yes, a person can open their eyes and still be in a coma, though classically a coma involves closed eyes; eye-opening often signals a transition to a Vegetative State (Unresponsive Wakefulness Syndrome) (UWS) or Minimally Conscious State, where the brainstem works for sleep-wake cycles but the cerebrum lacks awareness, meaning they look awake but don't meaningfully respond to commands or stimuli.
A state of complete unconsciousness with no eye-opening is called coma. A state of complete unconsciousness with some eye-opening and periods of wakefulness and sleep is called the vegetative state (VS). This refers to the “vegetative functions” of the brain (regulating body temperature, breathing, etc.)
The symptoms of a coma commonly include: Closed eyes. Depressed brainstem reflexes, such as pupils not responding to light. No responses of limbs except for reflex movements.
Some patients awaken from coma (that is, open the eyes) but remain unresponsive (that is, only showing reflex movements without response to command). This syndrome has been coined vegetative state.
Importantly, EEG can be used to help medical doctors diagnose how serious a person's coma is, according to their brain functions. Usually, coma patients have their eyes closed and cannot see what happens around them. But their ears keep receiving sounds from the environment.
Spontaneous movements may occur, and the eyes may open in response to external stimuli. Individuals may even occasionally grimace, cry, or laugh.
A coma can be very brief and last only a few minutes, or it can last as long as one to two weeks. Unfortunately, death is a possible complication. This is more likely with severe injuries, serious illness or delayed medical care. Most comas don't last more than a few weeks.
It's impossible to accurately predict whether the person will eventually recover, how long the coma will last and whether they'll have any long-term problems. Patients can gradually come out of the coma, some progress to a vegetative state (aka unresponsive wakefulness syndrome) and others die.
An individual who cannot respond to any aspects of the environment, even a painful stimulus, is considered to be in the deepest coma. An individual who can open eyes to command, or attempt to speak is at the upper limit of the comatose scale. GCS scares range from 3 [the most severe] to 15 [the least severe].
Annie Shapiro (1913–2003) was a Canadian apron shop owner who was in a coma for 29 years because of a massive stroke and suddenly awakened in 1992. After the patients in the true story Awakenings, Shapiro spent the longest time in a coma-like state before waking up. Her story inspired the 1998 movie Forever Love.
Stage 1: Unresponsiveness
During the unresponsive stage, a patient typically does not respond consistently. The unresponsive stage is referred to as a coma. Patients in the unresponsive stage may have reflexive responses and random movements for no specific reason.
People in a vegetative state go to sleep and awaken regularly, and their eyes open and move, but typically, they have lost all capacity for thought and conscious behavior.
It can have a variety of causes, including traumatic head injury, stroke, brain tumor, or drug or alcohol intoxication. A coma may even be caused by an underlying illness, such as diabetes or an infection. Coma is a medical emergency. Quick action is needed to preserve life and brain function.
Someone in a vegetative state is awake but shows no signs of awareness. For example, they may open their eyes but not respond to their surroundings. In rare cases, a person in a vegetative state may show some sense of response that can be detected using a brain scan, but not be able to interact with their surroundings.
Various spontaneous vertical eye movements, including ocular bobbing, can occur in patients with disorders of consciousness. True ocular bobbing is highly specific for focal pontine lesions, particularly when accompanied by horizontal gaze palsy.
In patients with a scale from 5 to 7, 53% will die or remain in a vegetative state, while 34% will have a moderate disability and/or good recovery. In patients with a Glasgow Coma Scale of 8 to 10, 27% will die or remain in a coma, while 68% will have a moderate disability and/or good recovery.
People who do wake up from a coma usually come round gradually. They may be very agitated and confused to begin with. Some people will make a full recovery and be completely unaffected by the coma. Others will have disabilities caused by the damage to their brain.
A condition of imminent brain death requires either a Glasgow Coma Score of 3 and the progressive absence of at least three out of six brain stem reflexes or a FOUR score of E0M0B0R0.
Coma is a state of consciousness that is similar to deep sleep, except no amount of external stimuli (such as sounds or sensations) can prompt the brain to become awake and alert. A person in a coma can't even respond to pain. A wide range of illnesses, conditions and events can cause coma.
Coma with eye-opening may occur with supratentorial, infratentorial, or global brain insults of various etiologies (e.g., stroke, anoxia). Brainstem involvement either as primary injury or secondary injury due to herniation appears to be a commonality among patients with eyes-open coma.
You may see eye movement and reaction to stimulation. The cause is from responses in the brain that remain intact after injury. But also because areas of the brain have begun to heal. Once patients react and can communicate, they move to the next stage of recovery.
Elaine Esposito (December 3, 1934 – November 25, 1978) held the record for the longest period of time in a coma according to Guinness World Records, having lost consciousness in 1941 and eventually dying in that condition more than 37 years later.
Someone in a coma needs intensive care in hospital. They may need help with breathing. They will be fed through a tube and they will receive blood and fluids through a drip inserted into their vein.
Stage 1: Unresponsiveness
You may hear this stage referred to as a coma. You may notice different movements in the patient. These are referred to as reflexive or generalized responses.
Consciousness is impaired to varying degrees. People in a stupor are usually unconscious but can be aroused with vigorous stimulation. People in a coma are unconscious, with their eyes closed, and they cannot be aroused. The brain damage or dysfunction that causes stupor and coma affects other parts of the body.