Mental Status Changes

Coma: a state of unconsciousness from which the patient cannot be aroused, even by powerful stimuli. Traumatic brain injuries are the most frequent cause; other causes include severe uncontrolled diabetes mellitus, liver disease, kidney disease, and neurologic conditions Dementia: a general loss of mental abilities, including impairment of memory and often impairments in speech, coordination, ability to understand sensory stimuli, and other mental faculties. Many different conditions can cause dementia; some are reversible and some are progressive with widespread damage in the brain Delirium: is an acute and debilitating decline in the ability to focus attention, perception, and cognition that produces...
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Mental Status Changes Mental Status Changes I. SOME DEFINITIONS Coma: a state of unconsciousness from which the patient cannot be aroused, even by powerful stimuli. Traumatic brain injuries are the most frequent cause; other causes include severe uncontrolled diabetes mellitus, liver disease, kidney disease, and neurologic conditions Dementia: a general loss of mental abilities, including impairment of memory and often impairments in speech, coordination, ability to understand sensory stimuli, and other mental faculties. Many different conditions can cause dementia; some are reversible and some are progressive with widespread damage in the brain Delirium: is an acute and debilitating decline in the ability to focus attention, perception, and cognition that produces an altered f orm of semi-consciousness. It is a systemic syndrome caused by a chemical or disease-process which is disrupting the neurons of the cerebral cortex. Though hallucinations and delusions are often present, the symptoms of delirium are clinically distinct fro m those induced by psychosis or hallucinogens. Stroke Syndrom: a symptom complex caused by a disorder of the blood vessels serving the brain, with impaired blood supply and ischemia. Symptoms depend on the brain area affected, and may include paralysis eit her on one entire side of the body or of a less complete area, vertigo, numbness, and aphasia. There are four different events related to this condition: transient ischemic attack, reversible ischemic neurologic deficit, stroke in evolution, and completed stroke. Persons most at risk for stroke include those with hypertension, atherosclerosis, heart disease, and other cardiovascular disorders. Obese persons, heavy smokers, and those with diabetes mellitus are also at increased risk. The three main causes of stroke syndrome, all associated with cerebral infarction (a necrotic area in the brain tissue), are cerebral embolism, cerebral thrombosis, and cerebral hemorrhage. Strokelike symptoms may also be caused by compression of cerebral vessels (such as by a tumor or edema) and by arterial spasm. Called also stroke and cerebral vascular or cerebrovascular accident. Mental Status: , describes induced changes in one's mental state, almost always temporary, is any condition which is significantly different from a n ormal waking beta wave state II. Etiology - Neurologic (stroke, delerium, ) - Metabolic: Hypoxemia, hypoglycemia - Toxic: drug effect, alcohol - Infection: Urinary tract infection, pneumonia. Infection is a common cause in elderly and patients with underlying neurologic disease III. DIAGNOSTIC History: Underlying dementia, neurologic or psychiatric or history of alcohol or drug uses Physical Examination: P11 of Washington Testing