Altered Mental Status

Abstract

: This article discusses causes of altered mental status, an initial approach to evaluating the patient, and elements of the advanced diagnostic workup. The article concludes with a general discussion of prevention and treatment.

Etiologies and Yield of Diagnostic Testing in Children Presenting to the Emergency Department with Altered Mental Status

“…Some adult studies explore the prevalence of altered mental status as well as general approaches to these patients in the ED, and others offer diagnostic and management guidelines for these patients. 1,2 However, a large subset of altered mental status studies in adult populations focus on delirium in the elderly population, [37][38][39][40][41][42] highlighting some important differences between prior studies in adults and our study. In the adult population, neurologic entities such as stroke and central nervous system malignancies or mass lesions appear to be the most common etiologies, 1,2 and our study does suggest that neurologic diagnoses are also the most common etiology for altered mental status in children.…”

Altered mental status is an indicator of mortality and associated with both infectious and non-communicable disease in Lilongwe, Malawi

“…Altered mental status (AMS) is a common chief finding among patients presenting to acute healthcare settings. 1 There is a broad spectrum of aetiologies associated with AMS, including infectious, metabolic, structural or traumatic causes, all of which may contribute significantly to morbidity and mortality. 2,3 Prompt diagnosis and treatment of the underlying problem is crucial to any improvement in patient outcomes.…”

Altered Mental Status in the Emergency Department

“…Other less common neurologic causes of AMS include neuropsychiatric lupus, Behçet's syndrome, vasculitis, acute disseminated encephalomyelitis, and autoimmune limbic encephalitis. 9 Wernicke's encephalopathy is a clinical diagnosis that presents with ataxia, ophthalmoplegia, and confusion. 50 Thiamine (vitamin B1) is an essential nutrient that serves as a cofactor, among several other functions, and is required by neurons and other supporting cells in the nervous system.…”

“…If a patient without a known neurologic disorder becomes delirious from a seemingly benign insult, outpatient follow-up with a neurologist should be arranged, as they have essentially failed a "stress test for the brain." 9 Disclosures J.H.H. is supported by the Veteran Affairs Geriatric Research, Education, and Clinical Center (GRECC).…”