Temperature

Fever usually indicates infection and, rarely, a brain stem or diencephalic lesion affecting the temperature centres.14 Most commonly the combination of fever and coma indicates systemic infection such as pneumonia or septicaemia, or a cerebral cause such as meningitis, encephalitis, or abscess. When seizures occur together with fever, the possibility of encephalitis or cerebral abscess is greatly increased. Heat stroke may present as febrile coma when the clue to the diagnosis is in the environment. Hypothermia is most commonly seen as a complication of an accident or cerebrovascular disease when an elderly patient is discovered, having lain for hours or days in an underheated room. This may also be seen following intoxication with alcohol or barbiturates, with peripheral circulatory failure and, rarely, with profound myxoedema.

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