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Altered mental status




Acute altitude sickness, Acute disseminated encephalomyelitis, Advanced sleep phase disorder, Bacterial meningitis, Basilar occlusion, Bilateral anterior cerebral artery occlusion, Bilateral internal carotid occlusion, Basal ganglia diseases Brain abscess, Brain damage, Brain edema, Brain infection Brain tumor, Brainstem hemorrhage, Brain stem infarction, Brainstem thrombencephalitis Central pontine myelinolysis, Cerebral hypoxia, Cerebral infarction, Cerebral malaria Cerebral oedema, Cerebral vasculitis, Cerebrovascular accident, Chest infection, Creutzfeldt-jakob disease, Decompression sickness, Delayed sleep phase syndrome, Dementia, Dialysis encephalopathy, Encephalitis, Encephalopathy Epidural abscess Epidural haemorrhage, Epidural hematoma, Epileptic seizures, Extradural hematoma, Fat emboli, Fits, Fungal meningitis, Gangrene , Head injury, Hepatic encephalopathy, Hydrocephalus, Hyperbaric sickness, Hyperosmolar non-ketotic diabetic coma, Hypertensive encephalopathy, Intracerebral hemorrhage, Intracranial granuloma, Intracranial space-occupying lesion, Korsakoff's Syndrome, Leukoencephalopathy, Lewy body dementia, Lyme disease Malaria Massive or bilateral supratentorial infarction, Meningitis, Meningoencephalitis, Multifocal leukoencephalopathy, Multiple sclerosis, Neurocysticercosis, Neurosyphilis, Nonconvulsive status epilepticus, Pain, Panayiotopoulos syndrome, Pick's disease , Plague , Pontine hemorrhage , Postictal state, [Encephalomyelitis[|Postinfectious encephalomyelitis]], Pyelonephritis, acute, Rabies , Raised intracranial pressure, Reversible posterior leukoencephalopathy syndrome, Reye's syndrome, Rickettsiae, Sagittal sinus thrombosis, Seizure, Sepsis

Sleeping sickness (East African), Sleeping sickness (West African), Stroke, Subarachnoid haemorrhage, Subdural empyema, Subdural haemorrhage

Surgical wound infection Systemic infection, systemic inflammatory response syndrome Typhoid fever Urinary tract infection Vancomycin resistant enterococcal bacteremia Venous sinus thrombosis Viral hemorrhagic fever,





Altered mental status has varying time courses and degrees of severity. Acute changes in mental status are usually secondary to delirium, stupor, and coma, which are forms of acute brain dysfunction. These changes occur over a period of hours or days and are usually precipitated by an underlying medical illness that is potentially life threatening. Chronic alterations in mental status (e.g. dementia) occur over a period of months and years and are less likely to be precipitated by a life-threatening illness. For these reasons, acute changes in mental status will be the focus of this review. Altered mental status is rarely caused by psychiatric illnesses such as depression or schizophrenia, and in elder patients, these should be diagnoses of exclusion. Acute brain dysfunction (delirium, stupor, and coma) and their underlying etiology should be ruled out prior to considering any psychiatric diagnoses, especially in patients without a previous history of psychiatric illness.

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