Template:AMS DDX

Altered mental status

• Diffuse brain dysfunction
  • 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