Altered mental status causes: Difference between revisions

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==Overview==
==Overview==
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.
Life threatening causes of altered mental status include [[malignant hypertension]], [[myocardial infarction]], [[rabies]] and [[sepsis]]. Other common causes of altered mental status include [[Alcohol|alcohol withdrawal]], [[dehydration]], [[electrolyte disturbance]] and [[hypoglycemia]].
==Causes==
==Causes==
===Life Threatening Causes===
===Life Threatening Causes===
*[[Carbon monoxide toxicity]]
*[[Heat stroke]]
*[[Hypothermia]]
*[[Malignant hypertension]]
*[[Myocardial infarction]]
*[[Rabies]]
*[[Sepsis]]


===Common Causes===
===Common Causes===
*[[Alcohol|Alcohol withdrawal]]
*[[Withdrawal|Drug withdrawal]]
*[[Dehydration]]
*[[Electrolyte disturbance]]
*[[Encephalitis]]
*[[Epileptic seizures]]
*[[Hyperglycemia]]
*[[Hypoglycemia]]
*[[Meningitis]]
*[[Sepsis]]


===Causes by Organ System===
===Causes by Organ System===
{|style="width: 80%; height: 100px; text-align: justify; text-justify: distribute;" border="1"
{|style="width: 80%; height: 100px; text-align: justify; text-justify: distribute;" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |[[Malignant hypertension]], [[Heart failure]], [[Myocardial infarction]], [[Congestive heart failure]], [[Ventricular arrhythmia]]
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |[[Carotid artery stenosis]], [[congestive heart failure]], [[cardiac output|decreased cardiac output ]],[[disseminated intravascular coagulation]], [[heart attack]], [[hypotension]], [[hypoxemia]], [[malignant hypertension]], [[myocardial infarction]], [[nonbacterial thrombotic endocarditis]], [[pulmonary embolism]], [[rheumatic fever]], [[shock]], [[sleep apnea]], [[stroke]], [[subacute bacterial endocarditis]], [[ventricular arrhythmia]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Chemical/Poisoning'''
| '''Chemical/Poisoning'''
|bgcolor="Beige"|Withdrawal states  from [[ethanol]], [[benzodiazepines]],[[Conium|Water hemlock poisoning]], [[Toxic mushrooms -- Monomethylhydrazine ]],[[Toluene]], [[Mescalbean|Texas Mescalbean poisoning]],[[Conium|Poison hemlock]], [[Organic solvent]], [[Methanol  ]], [[Marijuana]], [[Lead]], [[Datura stramonium|Jimson weed]], [[Hyperbaric sickness]], [[Hydrogen sulfide  ]], [[Heroin]] ,[[Hallucinogens]], [[Ethylene glycol]], [[Ethanol]], [[Daphne poisoning]], [[Cyanide]], [[Carbon tetrachloride]], [[Carbon monoxide toxicity]], [[Alcohol withdrawal]], [[Thallium|Thallium Sulfate poisoning]],[[Phencyclidine|Phencyclidine poisoning]], [[Nickel]], [[Carbonyl|Carbonyl poisoning]]  
|bgcolor="Beige"|[[Atropa belladonna|Atropa belladonna extract]], [[bromide]], [[Eastern brown snake|brown snake poisoning]], [[carbon monoxide poisoning]], [[carbon tetrachloride]], [[Carbonyl|carbonyl poisoning]], [[Snake venoms|coral snake poisoning]], [[cyanide]], [[daphne poisoning]], [[ethanol]], [[ethylene glycol]], [[gamma hydroxybutyrate]], [[hallucinogens]], [[heroin]], [[Hydrocarbon|hydrocarbon poisoning]], [[hydrogen sulfide]], [[hypomagnesemia]], [[Iron|iron compounds]], [[Jimson weed]], [[ketamine]], [[lead]], [[lithium]], [[Mandrake (plant)|mandrake]], [[manganese]], [[marijuana]], [[methanol]], [[Milk|milk poisoning]], [[nickel]], [[organic solvent]], [[paraldehyde]], [[perazine]], [[Phencyclidine|phencyclidine poisoning]], [[poison hemlock]], [[psilocybin]], [[snake bite]], [[spider bite]],[[Mescalbean|Texas Mescalbean poisoning]], [[Thallium|thallium sulfate poisoning]], [[toluene]], [[Conium|water hemlock poisoning]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"|[[Burns]], [[porphyria|chester porphyria]], [[plague]], [[porphyria]] 
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Muscle relaxants]], [[Serotonin syndrome]], [[Quinolones]], [[Lithium]], [[Drug withdrawal]], [[Drug overdose]],[[Cabergoline]], [[Antihistamines]], [[Antidepressants]]: for instance sedating [[tricyclic antidepressants]], [[Analgesics]]: mostly prescribed or illicit [[opiates]] such as [[oxycontin]], [[Antiepileptic]]s such as [[phenytoin]], [[carbamazepine]], [[gabapentin]], [[Antihistamines]]: [[diphenhydramine]] and [[doxylamine]], [[Antipsychotics]]: [[thioridazine]], [[quetiapine]], [[olanzapine]], [[risperidone]], and [[ziprasidone]] but not [[haloperidol]], [[HIV]] medications for example, [[efavirenz]], [[Antihypertensive]] medications like [[amlodipine]], [[Hypnotics]] like [[zopiclone]], or the [[benzodiazepine]] such as [[diazepam]] or [[nitrazepam]] and the [[barbiturate]], such as [[amobarbital]] or [[secobarbital]], Benzodiazepine receptor agonists: [[Eszopiclone]], [[Zolpidem]], [[Zaleplon]], [[Dopamine agonists]] used in the treatment of [[parkinson's disease]] e.g. [[pergolide]], ropinirole and [[pramipexole]], [[Antiepileptic]]s such as [[phenytoin]], [[carbamazepine]], [[gabapentin]]
|bgcolor="Beige"|[[Acyclovir]], [[alfentanil]], [[alphaprodine]], [[amantadine]], [[amiloride]], [[aminoglycosides]], [[aminophylline]], [[amitriptyline]], [[amlodipine]][[amobarbital]], [[amphetamine]], [[amphotericin B]], [[analgesics]], [[antiarrhythmics]], [[anticholinergics]], [[antidepressants]], [[antiemetics]], [[antihistamines]] [[antimalarials]], [[antipsychotic agents]], [[antispasmodics]], [[apomorphine]], [[aripiprazole]], [[armodafinil]], [[amobarbital]], [[asparaginase]], [[aspirin]], [[atropine]], [[baclofen]], [[barbiturates]], [[benzodiazepines]], [[beta blockers]], [[blinatumomab]], [[bromocriptine]], [[bupivacaine]], [[buprenorphine]], [[butorphanol]], [[cabergoline]], [[Paregoric|camphorated opium tincture]], [[carbamazepine]], [[cephalosporins]], [[chlophedianol]], [[chloroquine]], [[chlorpheniramine]], [[chlorpromazine]],[[cholinesterase inhibitors]], [[cinnarizine]], [[ciprofloxacin]], [[clomethiazole]], [[clonazepam]], [[clonidine]], [[clozapine]], [[cocaine]], [[codeine]], [[corticosteroids]], [[cyclazocine]], [[cyclobenzaprine]], [[cycloserine]], [[deserpidine]], [[desipramine]], [[dexamfetamine]], [[dextromoramide]], [[dezocine]], [[diamorphine]], [[diazepam]], [[digoxin]], [[dihydrocodeine]], [[diphenhydramine]], [[dipipanone]], [[disulfiram]], [[diuretics]], [[domperidone]], [[donepezil]], [[dopamine agonists]], [[dothiepin]], [[doxylamine]], [[drug overdose]], [[drug withdrawal]], [[efavirenz]], [[eszopiclone]], [[ethosuximide]], [[ethotoin]], [[ethylmorphine]], [[fentanyl]], [[fludarabine]], [[fluoroquinolones]], [[gabapentin]], [[general anaesthesia]], [[glutethimide]], [[guanethidine]], [[hallucinogens]], [[histamine-2 receptor blocker]], [[hydromorphone]], [[hydroxyzine]], [[ifosfamide]], [[interferon]], [[interleukin]], [[isoniazid]], [[ketobemidone]], [[L-dopa]], [[lanatoside C]], [[lenalidomide]], [[levetiracetam]], [[levodopa]], [[levomepromazine]], [[levorphanol]], [[lidocaine]], [[linezolid]], [[lithium]], [[loperamide]], [[lorazepam]], [[lysergic acid diethylamide]], [[lysuride]], [[macrolides]], [[marijuana]], [[memantine]], [[meptazinol]], [[mescaline]], [[methadone]], [[methadyl acetate]], [[methcathinone]], [[methyldopa]], [[methyldopate]], [[methylenedioxymethamphetamine]], [[methylphenidate]], [[metronidazole]], [[mirtazapine]], [[monoamine oxidase inhibitors]], [[monomethylhydrazine]], [[morphine]], [[muscle relaxant]], [[mushrooms]], [[nabilone]], [[nalbuphine]], [[nalidixic acid]], [[nelarabine]], [[nitrazepam]], [[nonsteroidal anti-inflammatory drugs]], [[norfloxacin]], [[norpropoxyphene]], [[nortriptyline]], [[noscapine]], [[olanzapine]], [[opiates]], [[opium]], [[oxazepam]], [[oxycodone]], [[oxycontin]], [[oxymorphone]], [[papaveretum]], [[penicillins]], [[pentazocine]], [[perampanel]], [[pergolide]], [[pethidine]], [[phenazocine]], [[phencyclidine]], [[phenelzine]], [[phenobarbital]], [[phenoperidine]], [[phenothiazines]], [[phentermine]], [[phenytoin]], [[pholcodine]], [[piribedil]], [[piritramide]], [[pizotifen]], [[pomalidomide]], [[pramipexole]], [[prednisolone]], [[primidone]], [[prochlorperazine]], [[propoxyphene]], [[propranolol]], [[List of psychotropic medications|psychotropics]], [[quetiapine]], [[quinine]], [[quinolones]], [[ramelteon]], [[rasagiline]], [[remifentanil]], [[reserpine]], [[retigabine]], [[rifampin]], [[risperidone]], [[rivastigmine]], [[ropinirole]], [[salicylate]], [[secobarbital]], [[sedative hypnotics]], [[sedatives]], [[selective serotonin reuptake inhibitors]], [[selegiline]], [[skeletal muscle relaxant]], [[st John's wort]], [[steroid abuse]], [[sufentanil]], [[sulfonamides]], [[thioridazine]], [[tricyclic antidepressants]], [[zaleplon]], [[ziprasidone]], [[zolpidem]], [[zopiclone]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"|[[Presbyacusis]]
|-  
|-  
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"|[[Pituitary apoplexy]], [[Phaeochromocytoma]], [[Hypothyroidism]], [[Hypopituitarism]], [[Hypoglycemia]], [[Hyperthyroidism]],[[Diabetes|Hyperosmolar non-ketotic diabetic coma]], [[Hyperglycemia]], [[Hyperthyroidism]], [[Endocrine diseases|Elevated or depressed pituitary function]] ,[[Cushing's syndrome|Elevated]] or [[Adrenal insufficiency|depressed adrenal function]], [[Diabetic ketoacidosis]], [[Diabetic hypoglycemia]], [[Cushing syndrome]], [[Adrenal cortex insufficiency]] , [[Thyrotoxicosis]], [[Myxedema coma]], [[Pituitary apoplexy]]
|bgcolor="Beige"|[[Addisonian crisis]], [[adrenal cortex insufficiency]], [[Carcinoid syndrome|carcinoid crisis]], [[cushing syndrome]], [[diabetic coma]], [[diabetic hypoglycemia]], [[diabetic ketoacidosis]], [[Endocrine diseases|elevated or depressed adrenal function]], [[Endocrine diseases|elevated or depressed pancreas function]], [[Endocrine diseases|elevated or depressed pituitary function]], [[hyperglycemia]], [[hyperosmolar non-ketotic diabetic coma]], [[hyperosmolar syndrome|hyperosmolar states]], [[hyperthyroidism]], [[hypoglycemia]], [[hypopituitarism]], [[hypothyroidism]], [[myxedema coma]], [[phaeochromocytoma]], [[pituitary apoplexy]], [[thyrotoxicosis]]
|-  
|-  
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"|[[Hypothermia]], [[Hyperthermia]], [[Heat stroke]], [[Electric shock]], [[Decompression sickness]], [[Altitude sickness|Acute Altitude sickness]]
|bgcolor="Beige"|[[Altitude sickness|Acute altitude sickness]], [[decompression sickness]], [[electric shock]], [[heat stroke]], [[hyperthermia]], [[hypothermia]], [[sick building syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"|[[pancreas|Elevated or depressed pancreas function]], [[Liver failure|Chronic Liver failure]], [[Liver failure|Acute Liver failure]], [[Mesenteric ischemia]], [[Appendicitis]], [[diverticulitis|Acute diverticulitis]], [[Constipation]]
|bgcolor="Beige"|[[diverticulitis|Acute diverticulitis]], [[appendicitis]], [[Carcinoid syndrome|carcinoid crisis]], [[cirrhosis of liver]], [[constipation]], [[folate deficiency]], [[hepatic encephalopathy]], [[hepatic failure]], [[mesenteric ischemia]], [[mucormycosis]], [[Reye's syndrome]], [[Mucormycosis|rhinocerebral mucormycosis]] [[Mucormycosis|rhinocerebral zygomycosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"|[[Acute intermittent porphyria]], [[Adrenoleukodystrophy|adrenal leukodystrophy]], [[Porphyria|chester porphyria]], [[citrullinemia type 2]], [[Hereditary coproporphyria|coproporphyria hereditary]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"|[[Thrombocytosis]], [[Polycythemia]], [[Acute lymphoblastic leukemia natural history, complications and prognosis|Leukemic blast cell crisis]], [[Hypereosinophilia]]  
|bgcolor="Beige"|[[porphyria|Chester porphyria]], [[disseminated intravascular coagulation]], [[fat emboli]], [[folate deficiency]], [[hypovolemia]], [[internal bleeding]], [[hypercoagulable state]], [[hypereosinophilia]], [[leukostasis]], [[methemoglobinemia]], [[plague]], [[polycythemia]], [[porphyria]], [[Thrombophilia|prothrombotic state]], [[pulmonary embolism]], [[severe hemorrhage]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"|Postoperative [[stress]]
|bgcolor="Beige"|[[Neuroleptic malignant syndrome]], [[serotonin syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"|[[Viral hemorrhagic fever]], [[Vancomycin resistant enterococcal bacteremia]], [[Urinary tract infection]], [[Typhoid fever]], [[systemic inflammatory response syndrome]], [[Systemic infection]], [[Wound#infectionSurgical wound infection]], [[Subdural empyema]], [[Sleeping sickness (West African)]], [[Sleeping sickness (East African)]], [[Sepsis]], [[Rickettsiae]], [[Rabies ]], [[Pyelonephritis, acute]], [[Plague ]], [[Neurocysticercosis]],[[Malaria]], [[Central nervous system infection|Intraspinal abscess / granuloma, Intracranial abscess / granuloma]], [[Gangrene ]], [[Lower respiratory tract infection classification|Chest infection]], [[Cerebral malaria]],[[Central nervous system infection|Brain or epidural abscess]], [[Brain infection]], [[Infectious mononucleosis]] (glandular fever), [[Lyme disease]]  
|bgcolor="Beige"|[[Appendicitis]], [[bacterial meningitis]], [[bartonella infections]], [[brain abscess]], [[brain infection]], [[Brill-Zinsser disease]], [[cat scratch disease ]], [[cerebral abscess]], [[cerebral malaria]], [[Lower respiratory tract infection classification|chest infection]], [[Creutzfeldt-Jakob disease]], [[disseminated intravascular coagulation]], [[epidemic typhus]], [[epidural abscess]], [[Human Immunodeficiency Virus (HIV)|human immunodeficiency virus (HIV)]], [[infectious mononucleosis]], [[intracranial abscess]], [[ Intracranial abscess / granuloma|intracranial granuloma]], [[legionella infection]], [[listeria]], [[Lyme disease]], [[malaria]], [[mucormycosis]], [[neurocysticercosis]],[[neurosyphilis]], [[plague]], [[septicemia|postoperative septicemia]], [[pyelonephritis, acute]], [[rabies]], [[Epidemic typhus|recrudescent typhus]] [[Mucormycosis|rhinocerebral mucormycosis]], [[Rickettsiae]], [[sepsis]], [[septic shock]], [[sleeping sickness (East African)]], [[sleeping sickness (West African)]], [[streptococcal infections]], [[subacute bacterial endocarditis]], [[subdural empyema]], [[Infection|surgical wound infection]], [[syphilis]], [[systemic infection]], [[systemic inflammatory response syndrome]], [[typhoid fever]], [[urinary tract infection]], [[vancomycin resistant enterococcal bacteremia]], [[viral hemorrhagic fever]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| [[Fibromyalgia]]
|bgcolor="Beige"| [[Fat emboli]], [[gangrene]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"|[[Venous sinus thrombosis]], [[Raised intracranial pressure]], [[Postictal state]], [[Nonconvulsive status epilepticus]],[[Meningoencephalitis]], [[Meningitis]], [[Intracranial bleeding]], [[Hypertensive encephalopathy]], [[Epileptic seizures]], [[Epidural haemorrhage]],[[Encephalitis]], [[Encephalitis]], [[Cerebrovascular accident]], [[Cerebral oedema]], [[Cerebral infarction]], [[Brain tumor]], [[Brain abscess]], [[Subdural hematoma]], [[Epidural hematoma]], [[Subarachnoid hemorrhage]], [[Brain tumor]], [[Neurosyphilis]], [[Sleep apnea]], [[Cerebral edema|Brain edema]], [[Cerebral hypoxia]], [[Hydrocephalus]]
|bgcolor="Beige"|[[Acute altitude sickness]], [[acute disseminated encephalomyelitis]], [[advanced sleep phase syndrome|advanced sleep phase disorder]], [[bacterial meningitis]], [[Basilar artery|basilar occlusion]], [[Anterior cerebral artery|bilateral anterior cerebral artery occlusion]], [[Internal carotid artery|bilateral internal carotid occlusion]] , [[basal ganglia diseases]], [[brain abscess]], [[brain damage]], [[brain edema]], [[brain infection]], [[brain tumor]], [[brainstem stroke|brainstem hemorrhage]] [[brain stem infarction]], [[central pontine myelinolysis]], [[Cerebral abscess]], [[cerebral hypoxia]], [[cerebral infarction]], [[cerebral malaria]], [[cerebral oedema]], [[cerebral vasculitis]], [[cerebrovascular accident]], [[Creutzfeldt-Jakob disease]], [[decompression sickness]], [[delayed sleep phase syndrome]], [[dementia]], [[dialysis encephalopathy syndrome|dialysis encephalopathy]], [[encephalitis]], [[encephalopathy]], [[epidural abscess]], [[epidural haemorrhage]], [[epidural hematoma]], [[epileptic seizures]], [[extradural hematoma]], [[fat emboli]], [[fungal meningitis]], [[gangrene]], [[head injury]], [[hepatic encephalopathy]], [[hydrocephalus]], [[hyperbaric sickness]], [[hypertensive encephalopathy]], [[intracerebral hemorrhage]], [[intracranial abscess]], [[ Intracranial abscess / granuloma|intracranial granuloma]], [[intracranial space-occupying lesion]], [[Korsakoff's Syndrome]], [[leukoencephalopathy]], [[Lewy body dementia]], supratentorial infarction, [[meningitis]], [[meningoencephalitis]], [[Brain stem tumor|midline brainstem tumor]], [[Progressive Multifocal Leukoencephalopathy|multifocal leukoencephalopathy]], [[multiple sclerosis]], [[neurocysticercosis]], [[neurosyphilis]], [[nonconvulsive status epilepticus]], [[pain]], [[panayiotopoulos syndrome]], [[Pick's disease]], [[Intracranial haemorrhage|pontine hemorrhage]], [[postictal state]], [[encephalomyelitis|postinfectious encephalomyelitis]], [[raised intracranial pressure]], [[reversible posterior leukoencephalopathy syndrome]], [[Reye's syndrome]], [[Superior sagittal sinus thrombosis|sagittal sinus thrombosis]], [[seizure]], [[stroke]], [[subarachnoid haemorrhage]], [[subdural haemorrhage]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| '''Nutritional/Metabolic'''
|bgcolor="Beige"|[[Wilson's disease]], [[Wernicke's encephalopathy]], [[Vitamin B12 deficiency]], [[Thiamine (Vitamin B1) deficiency]], [[Niacin|Niacin deficiencies]], [[Folate  deficiency]], [[Acute intermittent porphyria]], [[Starvation]]  
|bgcolor="Beige"|[[Acute intermittent porphyria]], [[Adrenoleukodystrophy|adrenal leukodystrophy]], aminoacidemia, [[Milk-alkali syndrome|Burnett's syndrome]], [[citrullinemia type 2]], [[Cope's syndrome]], [[Hereditary coproporphyria|coproporphyria,hereditary]], [[folate deficiency]], [[hyperammonemia]], [[hypercalcaemia]], [[hyperglycemia]], [[hypermagnesemia]], [[hypernatremia]], [[hypocalcaemia]], [[hypoglycaemia]], [[hypokalaemia]], [[hypomagnesemia]], [[hyponatraemia]], [[Korsakoff's Syndrome]], [[lipid storage disorder]], [[Niacin|niacin deficiencies]], [[niacin deficiency]], [[pellagra]],[[Porphobilinogen synthase|porphobilinogen synthase deficiency]], [[starvation]], [[thiamine (Vitamin B1) deficiency]], [[vitamin B12 deficiency]], [[Wilson's disease]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"|[[Eclampsia]], [[Hyperestrogenism|hyperoestrogenic states]], [[preeclampsia ]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"|[[Brain tumor]], [[Carcinoid syndrome|carcinoid crisis]], [[Chronic myelogenous leukemia|leukemic blast cell crisis]], [[Brain stem tumor|midline brainstem tumor]], [[phaeochromocytoma]], [[Adult brain tumors classification|subependymoma]] 
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"|[[Alcoholism|Alcohol overdose]], [[drug overdose]], [[heroin overdose]], Illegal drug overdose
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"|[[Schizoaffective disorder ]], [[Advanced sleep phase syndrome|Advanced sleep phase disorder]], [[Delayed sleep phase syndrome]]
|bgcolor="Beige"|[[Advanced sleep phase syndrome|Advanced sleep phase disorder]], [[alcohol withdrawal]], [[Anxiety|anxiety state]], [[bipolar disorder]], [[brief psychotic disorder]], [[catatonia]], [[chronic fatigue syndrome]], [[delayed sleep phase syndrome]], [[dementia]], [[depression]], [[drug abuse]], [[hysteria]], [[Kleine–Levin syndrome]], [[Korsakoff's Syndrome]], [[Lewy body dementia]], [[mental health]], [[narcolepsy]], [[neuroleptic malignant syndrome]], [[stress|postoperative stress]], [[psychiatric disorders]], [[schizoaffective disorder]],[[schizophrenia]], [[suicide]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"|[[Respiratory failure]], [[Hypoxemia]], [[Hypercarbia]]
|bgcolor="Beige"|[[Respiratory failure]], [[hypoxemia]], [[hypercarbia]], [[acute altitude sickness]], [[Lower respiratory tract infection|chest infection]], [[fat emboli]],[[hypercapnia]], [[plague]], [[pulmonary embolism]], [[respiratory acidosis]], [[respiratory failure]], [[sleep apnea]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
| '''Renal/Electrolyte'''
|bgcolor="Beige"|[[Hypophosphatemia]], [[Hyponatremia causes|hypoosmolar states]], [[Hyponatremia]], [[Hypocalcemia]], [[Hyperosmolar syndrome|Hyperosmolar states]], [[Hypernatremia]],  
|bgcolor="Beige"|[[Milk-alkali syndrome|Burnett's syndrome]], [[Cope's syndrome]], [[electrolyte disturbance]], [[hypercalcaemia]], [[hypermagnesemia]], [[hypernatremia]], [[hyperphosphatemia]], [[hypocalcaemia]], [[hypoglycaemia]], [[hypokalaemia]], [[hypomagnesemia]], [[hyponatraemia]], [[hyperosmolar syndrome|hyperosmolar states]], [[hyponatremia causes|hypoosmolar states]], [[hypophosphatemia ]], [[interstitial nephritis]], [[kidney failure]], [[lactic acidosis]], [[membranoproliferative glomerulonephritis]], [[pyelonephritis, acute]], [[renal failure, acute]], [[renal failure, chronic]], [[respiratory acidosis]], [[uremia]], [[dehydration]]
[[Hypermagnesemia]], [[Hypercalcemia]], [[Hypomagnesemia]], [[Hyperphosphatemia]], [[Renal failure|Chronic Renal failure]], [[Renal failure|Acute Renal failure]], [[Uremia]], [[Dehydration]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"|[[Vasculitis]]
|bgcolor="Beige"|[[Chronic fatigue syndrome]], [[fibromyalgia]], [[vasculitis]], [[rheumatic fever]]
 
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"|[[Trauma]], [[Skull fracture]], [[Head injury]]
|bgcolor="Beige"|[[Electric shock]], [[electrocution]], [[head injury]], [[skull fracture]], [[trauma]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Urologic'''
| '''Urologic'''
|bgcolor="Beige"| [[Urinary Track Infection]]
|bgcolor="Beige"|No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"|[[porphyria|Coproporphyria]], [[Burns]], [[Chronic fatigue syndrome]]
|bgcolor="Beige"|[[Henbane]], [[Salvia divinorum|salvia]]  
|-
|-
|}
|}
===Causes in Alphabetical Order===
===Causes in Alphabetical Order===
{{columns-list|4|
{{columns-list|4|
*[[Acidosis]]
*[[Acidosis]]
*[[Adrenal insufficiency|Acute adrenal insufficiency]]
*[[Acute altitude sickness]]
*[[Acute altitude sickness]]
*[[Delirium|Acute confusional state]]
*[[Delirium|Acute confusional state]]
*[[Acute disseminated encephalomyelitis]]
*[[Acute disseminated encephalomyelitis]]
*[[encephalopathy|Acute encephalopathy]]
*[[Diverticulitis|Acute diverticulitis]]
*[[Diverticulitis|Acute diverticulitis]]
*[[Acute intermittent porphyria]]  
*[[Acute intermittent porphyria]]  
Line 159: Line 179:
*[[Antiepileptics]]
*[[Antiepileptics]]
*[[Antihistamines]]
*[[Antihistamines]]
*[[Antihistamines]]
*[[Antimalarials]]  
*[[Antimalarials]]  
*[[Antipsychotic agents]]  
*[[Antipsychotic agents]]  
Line 177: Line 196:
*[[Barbiturates]]
*[[Barbiturates]]
*[[Bartonella infections ]]  
*[[Bartonella infections ]]  
*[[Basilar occlusion]]  
*[[Basilar artery|Basilar occlusion]]  
*[[Benzodiazepines]]
*[[Benzodiazepines]]
*[[Beta blockers]]
*[[Beta blockers]]
*[[Anterior cerebral artery|Bilateral anterior cerebral artery occlusion]]
*[[Anterior cerebral artery|Bilateral anterior cerebral artery occlusion]]
*[[Bilateral internal carotid occlusion]]  
*[[Internal carotid artery|Bilateral internal carotid occlusion]]  
*[[Basal ganglia diseases]]  
*[[Basal ganglia diseases]]  
*[[Bipolar disorder]]  
*[[Bipolar disorder]]  
Line 192: Line 211:
*[[Brainstem stroke|Brainstem hemorrhage]]
*[[Brainstem stroke|Brainstem hemorrhage]]
*[[Brain stem infarction]]
*[[Brain stem infarction]]
*[[Brainstem thrombencephalitis]]  
*[[Bickerstaff's encephalitis|Brainstem encephalitis]]  
*[[Brief psychotic disorder]]
*[[Brief psychotic disorder]]
*[[Brill-Zinsser disease ]]
*[[Brill-Zinsser disease ]]
Line 209: Line 228:
*[[Carbon tetrachloride]]
*[[Carbon tetrachloride]]
*[[Carcinoid syndrome|Carcinoid crisis ]]
*[[Carcinoid syndrome|Carcinoid crisis ]]
*[[Cardiac failure]]
*[[Carotid artery stenosis]]
*[[Carotid artery stenosis]]
*[[Cat scratch disease ]]
*[[Cat scratch disease ]]
Line 222: Line 240:
*[[Cerebral vasculitis]]  
*[[Cerebral vasculitis]]  
*[[Cerebrovascular accident]]  
*[[Cerebrovascular accident]]  
*[[Chest infection]]
*[[Lower respiratory tract infection|Chest infection]]
*[[Porphyria|Chester porphyria]]
*[[Porphyria|Chester porphyria]]
*[[Chlophedianol]]
*[[Chlophedianol]]
Line 242: Line 260:
*[[Cocaine]]
*[[Cocaine]]
*[[Codeine]]
*[[Codeine]]
*[[Quinolones]]
*[[Congestive heart failure]]
*[[Congestive heart failure]]
*[[Constipation]]
*[[Constipation]]
Line 282: Line 299:
*[[Disulfiram]]
*[[Disulfiram]]
*[[Diuretics]]  
*[[Diuretics]]  
*[[D-lactic acidosis]]
*[[Domperidone]]
*[[Domperidone]]
*[[Donepezil]]
*[[Donepezil]]
Line 295: Line 311:
*[[Electrocution]]
*[[Electrocution]]
*[[Electrolyte disturbance]]
*[[Electrolyte disturbance]]
*[[Elevated or depressed adrenal function]]
*[[Endocrine diseases|Elevated or depressed adrenal function]]
*[[Elevated or depressed pancreas function]]  
*[[Endocrine diseases|Elevated or depressed pancreas function]]  
*[[Encephalitis]]
*[[Encephalitis]]
*[[Encephalopathy]]  
*[[Encephalopathy]]  
*[[Endocrine disturbance ]]
*[[Epidemic typhus  ]]
*[[Epidemic typhus  ]]
*[[Epidural haemorrhage]]
*[[Epidural hemorrhage]]
*[[Epidural hematoma]]
*[[Epidural hematoma]]
*[[Epileptic seizures]]  
*[[Epileptic seizures]]  
Line 327: Line 342:
*[[Head injury]]
*[[Head injury]]
*[[Heart attack]]
*[[Heart attack]]
*[[Heart failure]]
*[[Heat stroke]]
*[[Heat stroke]]
*[[Henbane]]
*[[Henbane]]
*[[Hepatic encephalopathy]]
*[[Hepatic encephalopathy]]
*[[Hepatic failure]]  
*[[Hepatic failure]]  
*[[Herbal agent overdose  ]]
*[[Heroin overdose]]  
*[[Heroin overdose]]  
*[[Histamine-2 receptor blocker]]  
*[[Histamine-2 receptor blocker]]  
Line 346: Line 359:
*[[Hyperammonemia]]
*[[Hyperammonemia]]
*[[Hyperbaric sickness]]  
*[[Hyperbaric sickness]]  
*[[Hypercalcaemia]]  
*[[Hypercalcemia]]  
*[[Hypercapnia]]
*[[Hypercapnia]]
*[[Hypercarbia]]  
*[[Hypercarbia]]  
Line 359: Line 372:
*[[Hypertensive encephalopathy]]  
*[[Hypertensive encephalopathy]]  
*[[Hyperthermia]]  
*[[Hyperthermia]]  
*[[Hyperthyroid]]
*[[Hyperthyroidism]]
*[[Hyperthyroidism]]
*[[Hypocalcaemia]]  
*[[Hypocalcaemia]]  
Line 387: Line 399:
*[[Intracranial abscess / granuloma ]]  
*[[Intracranial abscess / granuloma ]]  
*[[Intracranial space-occupying lesion]]  
*[[Intracranial space-occupying lesion]]  
*[[Iron compounds]]
*[[Iron|Iron compounds]]
*[[Isoniazid]]
*[[Isoniazid]]
*[[Jimson weed]]
*[[Jimson weed]]
Line 426: Line 438:
*[[Manganese]]
*[[Manganese]]
*[[Marijuana]]
*[[Marijuana]]
*[[Massive or bilateral supratentorial infarction]]
*[[Supratentorial infarction]]
*[[Medication side effects]]  
*[[Memantine]]
*[[Memantine]]
*[[Glomerulonephritis classification|Membranoproliferative glomerulonephritis  ]]
*[[Glomerulonephritis classification|Membranoproliferative glomerulonephritis  ]]
Line 434: Line 445:
*[[Mental health]]  
*[[Mental health]]  
*[[Meptazinol]]
*[[Meptazinol]]
*[[Glomerulonephritis classification|Mesangiocapillary glomerulonephritis type]]
*[[Mescaline]]
*[[Mescaline]]
*[[Mesenteric ischemia]]  
*[[Mesenteric ischemia]]  
*[[Methadone]]
*[[Methadone]]
*[[Methadyl acetate]]
*[[Methadyl acetate]]
*[[Methaemoglobinemia  ]]  
*[[Methemoglobinemia]]  
*[[Methanol]]
*[[Methanol]]
*[[Methcathinone]]  
*[[Methcathinone]]  
Line 448: Line 458:
*[[Metronidazole]]
*[[Metronidazole]]
*[[Brain stem tumor|Midline brainstem tumor]]  
*[[Brain stem tumor|Midline brainstem tumor]]  
*[[Milk|Milk poisoning ]]
*[[Milk|Milk poisoning]]
*[[Mirtazapine]]  
*[[Mirtazapine]]  
*[[Monoamine oxidase inhibitors]]  
*[[Monoamine oxidase inhibitors]]  
Line 483: Line 493:
*[[Oxazepam]]  
*[[Oxazepam]]  
*[[Oxycodone]]
*[[Oxycodone]]
*[[oxycontin]]
*[[Oxycontin]]
*[[Oxymorphone]]  
*[[Oxymorphone]]  
*[[Pain]]
*[[Pain]]
*[[Pain attack]]
*[[Panayiotopoulos syndrome]]  
*[[Panayiotopoulos syndrome]]  
*[[Papaveretum]]
*[[Papaveretum]]
Line 521: Line 530:
*[[Porphobilinogen synthase|Porphobilinogen synthase deficiency]]
*[[Porphobilinogen synthase|Porphobilinogen synthase deficiency]]
*[[Porphyria]]  
*[[Porphyria]]  
*[[Postictal state]]
*[[Postictal state]]
*[[Postictal state]]
*[[Encephalomyelitis|Postinfectious encephalomyelitis]]
*[[Encephalomyelitis|Postinfectious encephalomyelitis]]
Line 534: Line 542:
*[[Propoxyphene]]
*[[Propoxyphene]]
*[[Propranolol]]
*[[Propranolol]]
*[[Prothrombotic state]]  
*[[Thrombophilia|Prothrombotic state]]  
*[[Psilocybin]]
*[[Psilocybin]]
*[[Psychiatric disorders]]
*[[Psychiatric disorders]]
Line 540: Line 548:
*[[Pulmonary embolism]]  
*[[Pulmonary embolism]]  
*[[Pyelonephritis, acute]]
*[[Pyelonephritis, acute]]
*[[Quinine]]  
*[[Quinine]]
*[[Quinolones]]
*[[Quinolones]]
*[[Rabies]]
*[[Rabies]]
Line 548: Line 556:
*[[Epidemic typhus|Recrudescent typhus]]
*[[Epidemic typhus|Recrudescent typhus]]
*[[Remifentanil]]
*[[Remifentanil]]
*[[Renal failure, acute]]
*[[Renal failure, chronic]]  
*[[Renal failure, chronic]]  
*[[Reserpine]]
*[[Reserpine]]
Line 566: Line 573:
*[[Superior sagittal sinus thrombosis|Sagittal sinus thrombosis]]
*[[Superior sagittal sinus thrombosis|Sagittal sinus thrombosis]]
*[[Salicylate]]
*[[Salicylate]]
*[[Salvia]]
*[[Salvia divinorum|Salvia]]
*[[Schizoaffective disorder]]  
*[[Schizoaffective disorder]]  
*[[Schizophrenia]]
*[[Schizophrenia]]
*[[Sedative hypnotics]]
*[[Sedative hypnotics]]
*[[Sedatives]]
*[[Seizure]]
*[[Seizure]]
*[[Selective serotonin reuptake inhibitors]]
*[[Selective serotonin reuptake inhibitors]]
Line 599: Line 605:
*[[Sulfonamides]]
*[[Sulfonamides]]
*[[Infection|Surgical wound infection]]
*[[Infection|Surgical wound infection]]
*[[encephalopathy|Acute encephalopathy]]
*[[Syphilis]]
*[[Syphilis]]
*[[Systemic infection]]
*[[Systemic infection]]
Line 605: Line 610:
*[[Tacrolimus]]
*[[Tacrolimus]]
*[[Tapentadol]]
*[[Tapentadol]]
*[[Teen drug abuse]]
*[[Drug abuse|Teen drug abuse]]
*[[Temazepam]]
*[[Temazepam]]
*[[Temporal lobe epilepsy]]  
*[[Temporal lobe epilepsy]]  
*[[Tetrahydrocannabinol]]  
*[[Tetrahydrocannabinol]]  
*[[Dermatophyllum|Texas mescalbean poisoning]]
*[[Dermatophyllum|Texas mescalbean poisoning]]
*[[Intracerebral hemorrhage.|Thalamic hemorrhage]]
*[[Intracerebral hemorrhage|Thalamic hemorrhage]]
*[[Thallium]]
*[[Thallium]]
*[[Thebaine]]
*[[Thebaine]]
Line 625: Line 630:
*[[Tranquilizers]]  
*[[Tranquilizers]]  
*[[Transient global amnesia]]
*[[Transient global amnesia]]
*[[Trauma]]
*[[Trauma]]
*[[Trauma]]
*[[Tricyclic antidepressants]]
*[[Tricyclic antidepressants]]
*[[Trihexyphenidyl]]  
*[[Trihexyphenidyl]]  
*[[Typhoid fever]]
*[[Typhoid fever]]
*[[Unconscious state]]
*[[Uremia]]
*[[Uremia]]
*[[Uremic encephalopathy  ]]
*[[Uremic encephalopathy  ]]
Line 652: Line 655:
*[[Viral hemorrhagic fever]]
*[[Viral hemorrhagic fever]]
*[[Vitamin B12 Deficiency]]
*[[Vitamin B12 Deficiency]]
*[[Vitiligo mental retardation facial dysmorphism uremia ]]
*[[Craniofacial anomalies|Vitiligo mental retardation facial dysmorphism uremia]]
*[[Water hemlock poisoning]]
*[[Water hemlock poisoning]]
*[[Waterhouse-Friderichsen Syndrome]]
*[[Waterhouse-Friderichsen Syndrome]]
Line 660: Line 663:
*[[West Nile fever  ]]  
*[[West Nile fever  ]]  
*[[Wilson disease]]
*[[Wilson disease]]
*[[Withdrawal from drug or alcohol dependence]]
*[[Benzodiazepine withdrawal syndrome]]
*[[Benzodiazepine withdrawal syndrome]]
*[[Withdrawal states ]]
*[[Withdrawal|Withdrawal states]]
*[[Young mckeever squier syndrome  ]]
*[[Young mckeever squier syndrome  ]]
*[[Ziconotide]]
*[[Ziconotide]]

Latest revision as of 12:23, 30 November 2015

Altered mental status Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Pratik Bahekar, MBBS [2] Kiran Singh, M.D. [3]

Overview

Life threatening causes of altered mental status include malignant hypertension, myocardial infarction, rabies and sepsis. Other common causes of altered mental status include alcohol withdrawal, dehydration, electrolyte disturbance and hypoglycemia.

Causes

Life Threatening Causes

Common Causes

Causes by Organ System

Cardiovascular Carotid artery stenosis, congestive heart failure, decreased cardiac output ,disseminated intravascular coagulation, heart attack, hypotension, hypoxemia, malignant hypertension, myocardial infarction, nonbacterial thrombotic endocarditis, pulmonary embolism, rheumatic fever, shock, sleep apnea, stroke, subacute bacterial endocarditis, ventricular arrhythmia
Chemical/Poisoning Atropa belladonna extract, bromide, brown snake poisoning, carbon monoxide poisoning, carbon tetrachloride, carbonyl poisoning, coral snake poisoning, cyanide, daphne poisoning, ethanol, ethylene glycol, gamma hydroxybutyrate, hallucinogens, heroin, hydrocarbon poisoning, hydrogen sulfide, hypomagnesemia, iron compounds, Jimson weed, ketamine, lead, lithium, mandrake, manganese, marijuana, methanol, milk poisoning, nickel, organic solvent, paraldehyde, perazine, phencyclidine poisoning, poison hemlock, psilocybin, snake bite, spider bite,Texas Mescalbean poisoning, thallium sulfate poisoning, toluene, water hemlock poisoning
Dental No underlying causes
Dermatologic Burns, chester porphyria, plague, porphyria
Drug Side Effect Acyclovir, alfentanil, alphaprodine, amantadine, amiloride, aminoglycosides, aminophylline, amitriptyline, amlodipineamobarbital, amphetamine, amphotericin B, analgesics, antiarrhythmics, anticholinergics, antidepressants, antiemetics, antihistamines antimalarials, antipsychotic agents, antispasmodics, apomorphine, aripiprazole, armodafinil, amobarbital, asparaginase, aspirin, atropine, baclofen, barbiturates, benzodiazepines, beta blockers, blinatumomab, bromocriptine, bupivacaine, buprenorphine, butorphanol, cabergoline, camphorated opium tincture, carbamazepine, cephalosporins, chlophedianol, chloroquine, chlorpheniramine, chlorpromazine,cholinesterase inhibitors, cinnarizine, ciprofloxacin, clomethiazole, clonazepam, clonidine, clozapine, cocaine, codeine, corticosteroids, cyclazocine, cyclobenzaprine, cycloserine, deserpidine, desipramine, dexamfetamine, dextromoramide, dezocine, diamorphine, diazepam, digoxin, dihydrocodeine, diphenhydramine, dipipanone, disulfiram, diuretics, domperidone, donepezil, dopamine agonists, dothiepin, doxylamine, drug overdose, drug withdrawal, efavirenz, eszopiclone, ethosuximide, ethotoin, ethylmorphine, fentanyl, fludarabine, fluoroquinolones, gabapentin, general anaesthesia, glutethimide, guanethidine, hallucinogens, histamine-2 receptor blocker, hydromorphone, hydroxyzine, ifosfamide, interferon, interleukin, isoniazid, ketobemidone, L-dopa, lanatoside C, lenalidomide, levetiracetam, levodopa, levomepromazine, levorphanol, lidocaine, linezolid, lithium, loperamide, lorazepam, lysergic acid diethylamide, lysuride, macrolides, marijuana, memantine, meptazinol, mescaline, methadone, methadyl acetate, methcathinone, methyldopa, methyldopate, methylenedioxymethamphetamine, methylphenidate, metronidazole, mirtazapine, monoamine oxidase inhibitors, monomethylhydrazine, morphine, muscle relaxant, mushrooms, nabilone, nalbuphine, nalidixic acid, nelarabine, nitrazepam, nonsteroidal anti-inflammatory drugs, norfloxacin, norpropoxyphene, nortriptyline, noscapine, olanzapine, opiates, opium, oxazepam, oxycodone, oxycontin, oxymorphone, papaveretum, penicillins, pentazocine, perampanel, pergolide, pethidine, phenazocine, phencyclidine, phenelzine, phenobarbital, phenoperidine, phenothiazines, phentermine, phenytoin, pholcodine, piribedil, piritramide, pizotifen, pomalidomide, pramipexole, prednisolone, primidone, prochlorperazine, propoxyphene, propranolol, psychotropics, quetiapine, quinine, quinolones, ramelteon, rasagiline, remifentanil, reserpine, retigabine, rifampin, risperidone, rivastigmine, ropinirole, salicylate, secobarbital, sedative hypnotics, sedatives, selective serotonin reuptake inhibitors, selegiline, skeletal muscle relaxant, st John's wort, steroid abuse, sufentanil, sulfonamides, thioridazine, tricyclic antidepressants, zaleplon, ziprasidone, zolpidem, zopiclone
Ear Nose Throat Presbyacusis
Endocrine Addisonian crisis, adrenal cortex insufficiency, carcinoid crisis, cushing syndrome, diabetic coma, diabetic hypoglycemia, diabetic ketoacidosis, elevated or depressed adrenal function, elevated or depressed pancreas function, elevated or depressed pituitary function, hyperglycemia, hyperosmolar non-ketotic diabetic coma, hyperosmolar states, hyperthyroidism, hypoglycemia, hypopituitarism, hypothyroidism, myxedema coma, phaeochromocytoma, pituitary apoplexy, thyrotoxicosis
Environmental Acute altitude sickness, decompression sickness, electric shock, heat stroke, hyperthermia, hypothermia, sick building syndrome
Gastroenterologic Acute diverticulitis, appendicitis, carcinoid crisis, cirrhosis of liver, constipation, folate deficiency, hepatic encephalopathy, hepatic failure, mesenteric ischemia, mucormycosis, Reye's syndrome, rhinocerebral mucormycosis rhinocerebral zygomycosis
Genetic Acute intermittent porphyria, adrenal leukodystrophy, chester porphyria, citrullinemia type 2, coproporphyria hereditary
Hematologic Chester porphyria, disseminated intravascular coagulation, fat emboli, folate deficiency, hypovolemia, internal bleeding, hypercoagulable state, hypereosinophilia, leukostasis, methemoglobinemia, plague, polycythemia, porphyria, prothrombotic state, pulmonary embolism, severe hemorrhage
Iatrogenic Neuroleptic malignant syndrome, serotonin syndrome
Infectious Disease Appendicitis, bacterial meningitis, bartonella infections, brain abscess, brain infection, Brill-Zinsser disease, cat scratch disease , cerebral abscess, cerebral malaria, chest infection, Creutzfeldt-Jakob disease, disseminated intravascular coagulation, epidemic typhus, epidural abscess, human immunodeficiency virus (HIV), infectious mononucleosis, intracranial abscess, intracranial granuloma, legionella infection, listeria, Lyme disease, malaria, mucormycosis, neurocysticercosis,neurosyphilis, plague, postoperative septicemia, pyelonephritis, acute, rabies, recrudescent typhus rhinocerebral mucormycosis, Rickettsiae, sepsis, septic shock, sleeping sickness (East African), sleeping sickness (West African), streptococcal infections, subacute bacterial endocarditis, subdural empyema, surgical wound infection, syphilis, systemic infection, systemic inflammatory response syndrome, typhoid fever, urinary tract infection, vancomycin resistant enterococcal bacteremia, viral hemorrhagic fever
Musculoskeletal/Orthopedic Fat emboli, gangrene
Neurologic 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, central pontine myelinolysis, Cerebral abscess, cerebral hypoxia, cerebral infarction, cerebral malaria, cerebral oedema, cerebral vasculitis, cerebrovascular accident, 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, fungal meningitis, gangrene, head injury, hepatic encephalopathy, hydrocephalus, hyperbaric sickness, hypertensive encephalopathy, intracerebral hemorrhage, intracranial abscess, intracranial granuloma, intracranial space-occupying lesion, Korsakoff's Syndrome, leukoencephalopathy, Lewy body dementia, supratentorial infarction, meningitis, meningoencephalitis, midline brainstem tumor, multifocal leukoencephalopathy, multiple sclerosis, neurocysticercosis, neurosyphilis, nonconvulsive status epilepticus, pain, panayiotopoulos syndrome, Pick's disease, pontine hemorrhage, postictal state, postinfectious encephalomyelitis, raised intracranial pressure, reversible posterior leukoencephalopathy syndrome, Reye's syndrome, sagittal sinus thrombosis, seizure, stroke, subarachnoid haemorrhage, subdural haemorrhage
Nutritional/Metabolic Acute intermittent porphyria, adrenal leukodystrophy, aminoacidemia, Burnett's syndrome, citrullinemia type 2, Cope's syndrome, coproporphyria,hereditary, folate deficiency, hyperammonemia, hypercalcaemia, hyperglycemia, hypermagnesemia, hypernatremia, hypocalcaemia, hypoglycaemia, hypokalaemia, hypomagnesemia, hyponatraemia, Korsakoff's Syndrome, lipid storage disorder, niacin deficiencies, niacin deficiency, pellagra,porphobilinogen synthase deficiency, starvation, thiamine (Vitamin B1) deficiency, vitamin B12 deficiency, Wilson's disease
Obstetric/Gynecologic Eclampsia, hyperoestrogenic states, preeclampsia
Oncologic Brain tumor, carcinoid crisis, leukemic blast cell crisis, midline brainstem tumor, phaeochromocytoma, subependymoma
Ophthalmologic No underlying causes
Overdose/Toxicity Alcohol overdose, drug overdose, heroin overdose, Illegal drug overdose
Psychiatric Advanced sleep phase disorder, alcohol withdrawal, anxiety state, bipolar disorder, brief psychotic disorder, catatonia, chronic fatigue syndrome, delayed sleep phase syndrome, dementia, depression, drug abuse, hysteria, Kleine–Levin syndrome, Korsakoff's Syndrome, Lewy body dementia, mental health, narcolepsy, neuroleptic malignant syndrome, postoperative stress, psychiatric disorders, schizoaffective disorder,schizophrenia, suicide
Pulmonary Respiratory failure, hypoxemia, hypercarbia, acute altitude sickness, chest infection, fat emboli,hypercapnia, plague, pulmonary embolism, respiratory acidosis, respiratory failure, sleep apnea
Renal/Electrolyte Burnett's syndrome, Cope's syndrome, electrolyte disturbance, hypercalcaemia, hypermagnesemia, hypernatremia, hyperphosphatemia, hypocalcaemia, hypoglycaemia, hypokalaemia, hypomagnesemia, hyponatraemia, hyperosmolar states, hypoosmolar states, hypophosphatemia , interstitial nephritis, kidney failure, lactic acidosis, membranoproliferative glomerulonephritis, pyelonephritis, acute, renal failure, acute, renal failure, chronic, respiratory acidosis, uremia, dehydration
Rheumatology/Immunology/Allergy Chronic fatigue syndrome, fibromyalgia, vasculitis, rheumatic fever
Sexual No underlying causes
Trauma Electric shock, electrocution, head injury, skull fracture, trauma
Urologic No underlying causes
Miscellaneous Henbane, salvia

Causes in Alphabetical Order

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4

References

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