Confusion physical examination

Confusion Microchapters
Home
Patient Information
Overview
Pathophysiology
Causes
Differentiating Confusion from other Symptoms
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Confusion physical examination On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Confusion physical examination All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Confusion physical examination
CDC on Confusion physical examination
Confusion physical examination in the news
Blogs on Confusion physical examination
Directions to Hospitals Treating Confusion
Risk calculators and risk factors for Confusion physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

Overview

In cases of confusion, a physical examination helps in localizing the lesion if the cause is from the brain. It also gives clues to the underlying cause of the disease. A complete neurological examination may not be done due to a limitation of the patient's condition.

Physical Examination

General Examination

A comprehensive examination may be tough due to an altered mental status of the patient.

• Alertness
• General behavior
• Language or speech defects
• Level of arousal
• Presence of agitation, restlessness, hyperactivity, anxiety

Vital Signs

• Temperature: An increase in temperature is significant for some infective foci.
• Blood pressure: If the blood pressure is decreased, it can be indicative of shock and hypoperfusion.
• Pulse: If the pulse is increased, it may be correlated to a raise in temperature.
• Respiratory rate: There may be hyperventilation in a few conditions due to anxiety, but in severe cases leading to a coma, the respiratory rate may be compromised.

Neurologic

• Cranial nerve examination : This is limited by uncooperative patients. Funduscopic examination helps in checking for papilledema or hemorrhages. Checking for a gag reflex to ensure safe oral feeds and medications.
• Motor examination : This can help in diagnosing an underlying brain disease.
• Gait evaluation : This can be used to check for a cerebellar lesion.

Other

• Skull fracture - Trauma
• Neck stiffness - Meningitis
• Lip erosions - Ingestion of poisons
• Indwelling catheters - Sepsis
• Tongue bites - Seizures
• Neck swelling - Thyroid disease
• Signs of liver failure
• Excessive sweating - Dehydration, hypoglycemia