If you’ve watched Netflix’s Senior Year, you know that it centers around main character Stephanie Conway (Rebel Wilson), a former high school cheerleader who falls into a coma only to wake up 20 years later and still yearns for the title of Prom Queen. In the movie, Wilson’s character remembers everything in her life as it was before the coma, as if her brain had frozen in time. But what actually happens to the brain during a coma is still not fully understood by the medical community. In fact, many trance facts are overlooked in the movie (such as the fact that the trance lasted 20 years – this is actually a very rare event!).
Research into coma prevention and treatment techniques is ongoing, and the chances of a person awakening in a coma or surviving are highly dependent on the initial cause of the coma. Not to mention that it is physically challenging as for a person in a coma, loved ones also take on a “significant emotional burden,” studies say, as they transition to caregivers and decision makers about another person’s health. Whether you’re caring for a loved one who is in a coma or just wondering what a coma really is, here’s a primer on what you need to know about comas.
What is a coma actually? Signs and reasons
Simply put, a coma is a “state of loss of consciousness” that occurs over a long period of time, according to May Kim-Tenser, MD, a neurologist at Keck Medicine of USC. Dr. Kim Tenser explains that signs of coma include unresponsiveness to sound and “painful stimuli, except for reflexes.” People in a coma are “unaware of their environment.” Coma can be caused by a number of things, including:
- brain injury
- brain attack
- brain tumor
- seizures
- Hypoglycemia or hyperglycemia (high or low blood sugar, respectively) of primary diabetes
- Infection such as encephalitis or meningitis
- Medicines or poisons
To prevent brain swelling, a person can also be put into a medical coma through the use of anesthesia after a serious injury.
How long can you be in a coma?
Coma rarely last longer than several weeks, according to the Mayo Clinic, despite some famous examples of very long comas. According to Guinness World Records, Edward Obara suffered the longest recorded coma, at around 42 years old, due to a combination of diabetes and pneumonia that struck her in 1969 when she was 16. Pop culture, as in the movie “Senior Year”, where the coma lasts for 20 years. But comas of this length are rare because people who are in a coma for longer than several weeks may eventually transition to a permanent vegetative state or “brain death,” an “irreversible cessation” of all brain function. Some people who come out of a coma may develop further disabilities or complications as a result of the coma or its underlying cause.
What happens to the brain when you are in a coma?
Unfortunately, doctors don’t know much about what’s going on there. “It’s not clear what the brain does during a coma,” says Dr. Kim Tenser. Although, Dr. Kim Tenser noted that sometimes it depends on the cause of the coma. If the coma is caused by seizures, for example, “You can see [the seizures] that occur on an electroencephalogram (EEG), “a test that measures electrical activity in the brain.
The experience of a coma can also vary from person to person. Some people have lucid dreams or are aware of what is going on around them. Others may not remember anything that happened or experienced, mentally or in the “real world” while in a coma. Research shows that in some abilities people are able to hear while in a coma. A small 2015 study from Northwestern University found that patients who listened to familiar stories told by family members “recognized faster and improved recovery,” according to a Northwestern article about the study.
“We believe that hearing these stories in the voices of parents and siblings exercises the circuits in the brain responsible for long-term memories,” lead author Theresa Pape, assistant professor of physical medicine and rehabilitation, explained in the article. “This stimulation helped release the first glimmer of consciousness.” MRI scans showed increased brain activity as patients listened to stories, suggesting that — although we may not know exactly what happens in a coma — people in a coma can hear and, at some levels, perceive certain audio cues. those around them. As research into the coma continues, doctors are looking to discover more about what the brain does during a coma and how they can achieve a faster and more successful recovery.
How do people wake up from a coma?
“[Emerging from a coma] Something has to happen by itself and [is] It depends on the underlying cause of the coma,” explains Dr. Kim Tenser. However, doctors can provide some medical assistance in helping a patient wake up from the coma, but it depends on the nature and cause of the coma.
If uncontrolled seizures are behind the coma, doctors can administer medications to calm the seizures while monitoring the patient’s brain waves with an EEG. “Once the seizures stop, you may start to wake up slowly,” Dr. Kim Tenser explains.
If the coma is due to meningitis or encephalitis, patients can be treated with antibiotics or antivirals, respectively, and Dr. Kim Tenser says they will likely eventually wake up — although medical complications may occur. If swelling of the brain occurs, medications or surgical procedures may also be needed to relieve pressure.
Ultimately, a person who appears to be in a coma should be taken to the emergency room immediately. They may need immediate medical attention to help with breathing and circulation as well as any other medications to treat the cause of the coma.
