Abstracts

Rationale: To audit the electro-clinical, etiological and prognostic variables in patients with spindle coma (SC). Methods: A total of 39 patients with spindle coma on bedside EEG were included in this retrospective study. Clinical presentation, etiology and outcome of patients at discharge were abstracted as per a structured format.  Outcome was measured as modified Rankin Scale (mRS), categorizing patients into those with good outcome (mRS 1, 2 or 3) or poor outcome (mRS 4, 5 or 6). Results: CNS Infections (n=9, 23.08%) were the most common etiology for SC. Vascular causes, septic encephalopathy and drug intoxication were the other causes. Unusual cases of SC were dengue encephalitis, cerebral malaria and tuberculous meningitis. The majority of patients (69.23%) had good outcome at discharge. Absence of brainstem reflexes at initial assessment was significantly associated with poor outcome (p=0.02). Conclusions: To the best of our knowledge, this is the largest series of patients with SC.  SC is commonly seen with diffuse neurological dysfunction and indicates dysfunction of the reticular system at the midbrain level. We conclude that the etiological range of SC is wide and non-specific. We highlight the importance of neurological examination (especially brainstem reflexes) for predicting outcome in patients with SC. Funding: Nil