Coma due to hypertensive encephalopathy in neonates usually occurs when systolic blood pressure is greater than 106 mm Hg. Treatment of hypertensive encephalopathy consists of hydralazine 1 mg/kg per dose, followed by diazoxide 2 mg/kg and nitroprusside 0.25 to 0.5 mg/kg per minute if necessary. The etiology of the hypertension should be determined and corrected if possible.
Coma due to hypoglycemia is diagnosed if serum glucose is below 40 mg/dL. Patients with hypoglycemic coma present with hypotonia, jitteriness, and respiratory difficulties prior to becoming comatose. The mechanism causing hypoglycemia should be elicited. Possible mechanisms include hyperinsulinism, endocrine deficiencies, and inborn errors of metabolism. Treatment consists of correcting hypoglycemia and eliminating its causes. More about ...40, 110
Polycythemia may produce coma. Neonatal polycythemia is defined as central venous hematocrit greater than 65%. Polycythemic neonates look plethoric and have signs of respiratory distress and congestive heart failure. Treatment consists of partial exchange transfusion.