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NEUROLOGY 1988;38:1275
© 1988 American Academy of Neurology

Reversible coma with prolonged absence of pupillary and brainstem reflexes

An unusual response to a hypoxic-ischemic event in MS

Robert A. Ringel, MD, Jack E. Riggs, MD and John F. Brick, MD

Department of Neurology, West Virginia University School of Medicine, Morgantown, WV.

A quadriparetic man with multiple sclerosis became comatose with absent pupillary and brainstem reflexes for 48 hours following a respiratory arrest. A periodic electroencephalographic pattern was recorded 12 hours after arrest suggesting a poor prognosis. Despite the poor prognostic signs, clinical recovery to baseline occurred within 2 weeks. Reversible coma with absent pupillary and brainstem reflexes may occur in MS patients for prolonged periods and lead to potential errors in prognosis if not recognized.

Address correspondence and reprint requests to Dr. Ringel, Department of Neurology, West Virginia University School of Medicine, Morgantown, WV 26506.

Received June 12, 1987. Accepted for publication in final form December 18, 1987.




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