​Symptoms and Signs – Differential Diagnosis of Coma in Pediatric Cases 
ANOXIA
• Birth asphyxia
• Carbon monoxide (CO) poisoning
• Croup/epiglottitis
• Meconium aspiration
INFECTION
• Hemolysis
• Blood loss
• Hydrops fetalis
• Meningoencephalitis
• Sepsis
• Postimmunization encephalitis
INCREASED INTRACRANIAL PRESSURE
• Anoxia
• Inborn metabolic errors
• Toxic encephalopathy
• Reye’s syndrome
• Head trauma/intracranial bleed
• Hydrocephalus
• Posterior fossa tumors
HYPERTENSIVE ENCEPHALOPATHY
• Coarctation of aorta
• Nephritis
• Vasculitis
• Pheochromocytoma
ISCHEMIA
• Hypoplastic left side of heart
• Shunting lesions
• Aortic stenosis
• Cardiovascular collapse (any cause)
PURPURIC CAUSES
• Disseminated intravascular coagulation
• Hemolytic-uremic syndrome
• Leukemia
• Thrombotic purpura
HYPERCAPNIA
• Cystic fibrosis
• Bronchopulmonary dysplasia
• Congenital lung anomalies
NEOPLASM
• Medulloblastoma
• Glioma of brainstem
• Posterior fossa tumors
DRUGS/TOXINS
• Maternal sedation
• Alcohol
• Any drug
• Lead
• Salicylism
• Arsenic
• Pesticides
ELECTROLYTE ABNORMALITIES
• Hypernatremia (diarrhea, dehydration, salt poisoning)
• Hyponatremia (syndrome of inappropriate antidiuretic hormone [SIADH], androgenital syndrome, gastroenteritis)
• Hyperkalemia (renal failure, salicylism, androgenitalism)
• Hypokalemia (diarrhea, hyperaldosteronism, salicylism, diabetic ketoacidosis [DKA])
• Hypocalcemia (vitamin D deficiency, hyperparathyroidism)
• Severe acidosis (sepsis, cold injury, salicylism, DKA)
HYPOGLYCEMIA
• Birth injury or stress
• Diabetes
• Alcohol
• Salicylism
• Hyperinsulinemia
• Iatrogenic
POSTSEIZURE
• Renal causes: nephritis, hypoplastic kidneys
• Hepatic causes: acute hepatitis, fulminant hepatic failure, inborn metabolic errors, bile duct atresia