Altered mental status: Difference between revisions

Revision as of 17:10, 24 March 2015

Alteration of arousal or content of consciousness or both
Both cerebral cortices or brainstem must be affected
Delirium vs dementia vs psych
Must quickly determine if coma is from diffuse or focal impairment
Peds
- Most common causes are toxic ingestion, infection, and child-abuse induced trauma

Depends on cause
- Diffuse brain dysfunction - lack of focal findings
- Focal brain dysfunction - hemiparesis, loss of motor tone, loss of ocular reflexes

Tintinalli

Authors:

@@ Line 13: / Line 13: @@
 ==Differential Diagnosis==
-#Diffuse brain dysfunction
+{{AMS DDX}}
-##Encephalopathies
-###Hypoxic encephalopathy
-###Metabolic encephalopathy
-####[[Hypoglycemia]]
-####Hyperosmolar state (e.g., [[hyperglycemia]])
-####[[Electrolyte Abnormalities]] ([[hypernatremia]] or [[hyponatremia]], [[hypercalcemia]])
-####Organ system failure
-####[[Hepatic Encephalopathy]]
-####[[Uremia]]/[[Renal Failure]]
-####Endocrine (Addison disease, [[hypothyroidism]])
-####Hypoxia
-####CO2 narcosis
-###[[Hypertensive Encephalopathy]]
-##Toxins
-##Drug reactions (NMS)
-##Environmental causes
-###[[Hypothermia]]
-###[[Hyperthermia]]
-##Deficiency state
-###[[Wernicke encephalopathy]]
-##[[Sepsis]]
-#Primary CNS disease or trauma
-##Direct CNS trauma
-###Diffuse axonal injury
-###Subdural/epidural hematoma
-##Vascular disease
-###Intraparenchymal hemorrhage
-##[[SAH]]
-##Infarction
-###Hemispheric, brainstem
-##CNS infections
-##Neoplasms
-##[[Seizures]]
-###Nonconvulsive status epilepticus
-####Consider if motor activity of seizure has stopped but pt is not alert w/in 30min
-###Postictal state
 ==Work-Up==