Altered mental status

Altered mental status is a topic covered in the Diagnosaurus.

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DDx

Drugs

  • Opioids, alcohol, sedatives, antipsychotics, withdrawal, others

Metabolic

  • Hypoxia, hypoglycemia, hyperglycemia, hypercalcemia, hypernatremia, hyponatremia, uremia, hepatic encephalopathy, hypothyroidism, hyperthyroidism, vitamin B12 or thiamine deficiency, carbon monoxide poisoning, Wilson’s disease

Infectious

  • Meningitis, encephalitis, bacteremia, urinary tract infection, pneumonia, neurosyphilis

Structural

  • Space-occupying lesion, eg, brain tumor, subdural hematoma, hydrocephalus

Vascular

  • Stroke, subarachnoid hemorrhage, coronary ischemia, hypertensive encephalopathy, CNS vasculitis, thrombotic thrombocytopenic purpura, disseminated intravascular coagulation, hyperviscosity

Psychiatric

  • Schizophrenia, depression, mania

Other

  • Seizure, nonconvulsive status epilepticus, hypothermia, heat stroke, ICU psychosis, "sundowning"

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Last updated: March 5, 2015