Coma is an everyday problem of clinicians. The assessment of the cause, as soon as possible, is most important for the problem solving. We need to work sometimes without history and in these cases the most helpful are signs which we reach using our senses- sight, touch, smell and hearing. First of all we exclude intoxication, thenafter cerebral disturbances - comas with normal or pathological computed tomography finding and then we can pay attention to metabolic disorders as causes of coma. Simultaneously we need to start with supportive cardiopulmonal therapy and/or ,if we have identified agens, with antidotes.