Abstract
Spindle coma is an electroclinical entity in which physiologic sleep patterns, such as sleep spindles in the 9 to 14 Hz range, vertex sharp waves, and K complexes, superimposed on a background of delta and theta activity, occur synchronously in patients with altered consciousness.1 Spindle coma has been associated with structural (traumatic and nontraumatic) and nonstructural causes,2 such as cerebrovascular disease, tumor, surgery, hypoxia, seizure, drug intoxication, metabolic disturbances, and vasovagal syncope.2,3 We report three cases of spindle coma secondary to limited paramedian midbrain infarction, in which the prognosis was favorable. ### Patient 1. A 35-year-old woman presented with decreased consciousness. At the emergency room, she was comatose, with decreased and shallow respiratory effort. She had Takayasu’s disease, diagnosed 15 years previously, and was in remission. Neurologic examination showed vertical gaze ophthalmoplegia, loss of pupillary reflexes, and preserved flexor responses to pain with motor power of Medical Research Council (MRC) grade 2/5. Brain MRI revealed an isolated right paramedian midbrain infarction with thrombosis at the distal …
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
