Interpret coma with a localization lens, not a single bedside score. Brainstem reflexes, breathing pattern, and the possibility of covert cognition are more useful than assuming a low motor response means irrecoverable injury.

Mortality rates sit between 10% and 20%, and survivors face significant risks of rhabdomyolysis, cardiac arrhythmias, and developing long-term epilepsy; 2024 study revealed it is remarkably common, appearing in 25% of individuals diagnosed as being in a coma, vegetative state, or minimally conscious state; Unfortunately, about 80% of individuals in an alpha coma never regain consciousness; Breathing pattern gives great localization clues; Cheyne-Stokes respiration points to a lesion above the thalamus or diencephalon