Encephalopathy physical examination

Encephalopathy
Home
Patient Information
Overview
Classification
Pathophysiology
Causes
Differentiating Encephalopathy from other Diseases
Epidemiology & Demographics
Risk Factors
Screening
Natural History, Complications & Prognosis
Diagnosis
Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Electroencephalogram
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Encephalopathy physical examination On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Encephalopathy 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 Encephalopathy physical examination
CDC on Encephalopathy physical examination
Encephalopathy physical examination in the news
Blogs on Encephalopathy physical examination
Directions to Hospitals Treating Encephalopathy
Risk calculators and risk factors for Encephalopathy 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]

Appearance of the Patient

The appearance is mainly depends upon the severity of the condition and the cause. The patient is often confused. The patient may appear anxious and may have difficulty in breathing. There may be quite to a few signs of injury which may be due to trauma.

Vitals

Temperature

• Increased in infections, thyroiditis

• Decreased in severe sepsis

Pulse

Rate

• Tachycardia may be present in cases of thyroiditis and infections
• Bradycardia may be present in dehydration, loss of blood volume and severe sepsis

Rhythm

• The pulse is regular

Strength

• The pulse may be weak in cases of dehydration and hemorrhages

Symmetry

• The pulses are symmetric

Blood Pressure

• Hypotension may be present in cases of loss fluids , sepsis and low blood volume
• Hypertension may be present in cases of severe hypertensive encephalopathy

Respiratory Rate

• Tachypnea may be present in cases of pulmonary edema caused due to increase in blood pressure or due to multi organ failure

• Cheyne-Stokes respirations - an altered breathing pattern seen with brain damage and coma

Skin

• Cyanosis may be present in severe hypoxia and poisoning
• Jaundice may be present liver failure and in neonatal encephalopathy
• A rash may be present owing to a viral infection

Head

• No obvious signs on head.
• Skull fractures may be evident in cases of trauma

Eyes

• Icteric sclera may be present
• Nystagmus may be seen in a few cases of cranial nerve disease
• Papilledema, hemorrhages, exudates seen in hypertensive encephalopathy

Ears, Nose, Throat (ENT)

• No significant findings
• Injuries if trauma

Neck

• Jugular venous pressure may be elevated
• Thyromegaly may be present

Lungs

• Pulmonary edema and rales may be present
• Lung consolidation - in case of infections

Heart

• S1 Normal
• S2 Normal
• S3 may be heard in hypertensive cases

Abdomen

• Abdominal distention may be present
• Abdominal tenderenss may be present
• Rebound may be present
• An acute abdomen may be present
• An abdominal mass may be present
• Hepatomegaly may be present
• Splenomegaly may be present

Neurologic

Complete physical examination may not be possible in a few cases of severe complications.

General examination

• Myoclonus (involuntary twitching of a muscle or group of muscles)
• Nystagmus (rapid, involuntary eye movement)
• Tremor
• Muscle atrophy and weakness
• Dementia
• Seizure
• Loss of ability to swallow
• Loss of ability to speak

Complete physical examination may not be possible in a few cases of severe complications.

References

Template:WH Template:WS