12/27/2022 0 Comments Altered mental status differential![]() ![]() 12 – 14Įlectroencephalography is an important study to rule out nonconvulsive seizures, which may occur in 8% to 30% of patients with AMS without an obvious cause. Noncontrast computed tomography of the head is the initial study for most patients. Unless the etiology is clear and the risk of intracranial pathology is low, neuroimaging should be part of the initial assessment of recent changes in mental status. Systematic review, narrative review, and expert consensus Medications should be used only when nonpharmacologic treatments are ineffective.ĭelirium is common but frequently overlooked, and it is associated with serious medical conditions therefore, screening should always be considered in patients with acute AMS, especially in those at high risk. Physical restraints should rarely be used and only for the shortest time possible. When intervention is needed to control patient behaviors that threaten themselves or others, nonpharmacologic interventions are preferred to medications. ![]() The underlying etiology determines the definitive treatment. ![]() Patients at increased risk of AMS benefit from preventive measures. Lumbar puncture and electroencephalography are also important diagnostic tests in the evaluation of AMS. Neuroimaging with computed tomography or magnetic resonance imaging should be performed when the initial evaluation does not identify a cause or raises concern for intracranial pathology. Laboratory testing, chest radiography, and electrocardiography help diagnose infections, metabolic disturbances, toxins, and systemic conditions. A history and physical examination guide diagnostic testing. Clinicians should identify and treat reversible causes of the AMS, some of which require urgent intervention to minimize morbidity and mortality. Delirium is also an important manifestation of AMS, especially in older people who are hospitalized. Potential precipitating factors for the recent onset of altered mental status (AMS) include primary central nervous system insults, systemic infections, metabolic disturbances, toxin exposure, medications, chronic systemic diseases, and psychiatric conditions. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |