Unconsciousness

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: LOC: non responsive; unresponsive; non-responsive; non-responsiveness; unresponsiveness; lack of responsiveness; lack of response; reduced alertness; disturbance of consciousness; decreased level of consciousness; decreased LOC; decreased consciousness; partial loss of consciousness

Overview

Unconsciousness, more appropriately referred to as loss of consciousness or lack of consciousness, is a dramatic alteration of mental state that involves complete or near-complete lack of responsiveness to people and other environmental stimuli.

Causes

Common Causes

• Alcohol
• Brownout or greyout, a partial loss of consciousness
• Cardiac arrest
• Coma
• Fainting
• Fatigue
• Hypnotic drugs
• Sedatives
• Stroke
• Syncope
• Traumatic brain injury

Causes by Organ System

Cardiovascular	Cardiac arrest, Pulmonary arteriovenous fistula, Shock, Syncope, Ventricular fibrillation, Fat embolism
Chemical / poisoning	1,1-Dichloroethene, 1,4-Dioxane, 2,4-Dinitrotoluene, 2-Methyl-4-Chlorophenoxyacetic Acid, Acetone, Acetophenone, Acute varnish makers' and painters' Naptha, Allyl alcohol, Allyl chloride, Allyl trichloride, Aluminum phosphide, Amidithion, Amiton, Aniline, Antifreeze, Athyl-Gusathion, Azinophos-methyl, Azinfos-ethyl, Azinphosmetile, Azothoate, Benoxafos, Bromophos, Cadusafos, Cannabinoids, Carbon monoxide, Carbon tetrachloride, Carbophenothion, Chlorfenvinphos, Chlorobenzene, Chloropyrifos, Chlorpyrifos methyl, Claviceps purpurea, Cone shell , Cyanides, Cyanthoate, Cyclohexanone, Demeton, Demeton-methyl, Demeton-O, Demeton-O-methyl, Demeton-S-methyl, Demeton-S-methylsulphon, Dialifos, Diazinon, Dichlorvos, Dicrotophos, Diethylene glycol, Dimethoate, Dimethyl phthalate, Dioxathion, Disulfoton, Earthball, Endosulfan, Endothion, Ethinamate, Ethion, Ethoate-methyl, Ethoprophos, Ethyl mercaptan, Ethylbenzene, Ethyl-guthion, Etrimfos, Fenchlorphos, Fenitrothion, Fensulfothion, Fenthion, Fonophos, Formothion, Guthion-ethyl, Heptenophos, High melting explosive , Insect allergy, Iodofenphos, Jet Fuel-4, Jet Fuel-8, Malathion, Mecarbam, Methacrifos, Methamidophos, Methane, Methidathion, Methiocarb, Methomyl, Methyl ethyl ketone, Methyl mercaptan, Methyl parathion, Methyl tert-butyl ether, Methylene Chloride, Metiltriazotion, Mevinphos, Monocrotophos, N,N-Dimethyl-P-Toluidine, Naphthalene, Nitroethane, Nitromethane, Nitrophenol, Nitrophenol Urea, Omethoate, Oxydeprofos, Oxydisulfoton, Parathion, Parathion Methyl, Pentaborane, Pentachlorophenol, Phenkapton, Phorate, Phosalone, Phosdrin, Phosmet, Phosphamidon, Phosphine, Phoxim, Pine oil, Pirimiphos-methyl, Primiphos methyl, Profenofos, Propylene glycol dinitrate, Prothidathion, Prothoate, Pyridine, Pyrimitate, Quinalphos, Quintiofos, RDX, Selenium, Sodium azide, Sodium hypochlorite, Sophamide, Stoddard solvent, Sulfotep, Terbufos, Tetrachloroethylene, Tetraethyl Pyrophosphate, Tetrahydrocannabinol, Tetrahydrofuran, Thiometon, Tolclofos methyl, Toluene, Triazophos, Triazotion, Trichlorfon, Trichloroethane, Triclofos, Trifenfos, Vamidothion, Vinyl Choride, Water hemlock poisoning, Xylene, Zinc Phosphide, Iron compounds, Organophosphorous compounds
Dermatologic	No underlying causes
Drug Side Effect	Atropine, Baclofen, Buprenorphine, Buspirone, Chlophedianol, Chloral hydrate, Chlorpheniramine, Chlorpromazine, Cinnarizine, Clomipramine, Clonazepam, Clotiapine, Cocaine, Codeine, Cyclobenzaprine, Cycloserine, Dantrolene, Demerol , Demethyldiazepam, Deserpidine, Desipramine, Diamorphine, Diazepam, Dichloralphenazone, Diphenhydramine, Diphenidol, Dothiepin, Doxepin , Efavirenz, Eszopiclone, Ethchlorvynol, Flurazepam , Fluridrazepam, Gabapentin, Gamma hydroxybutyrate, Ganaxolone, General anaesthesia, Glutethimide, Haloperidol, Hydrazine, Hydroxyzine, Imipramine, Inhalational anaesthetics, Iron compounds, Levetiracetam, Levomepromazine, Lidocaine, Local anaesthetia, Lofexidine, Lorazepam, Medazepam, Melatonin, Mephenoxalone, Meprobamate, Methadone, Methaqualone, Methyldopa, Methyprylon, Metoclopramide, Mianserin, Midazolam, Mirtazapine, Morphine, Nabilone, Nitrazepam, Nitrous oxide, Nortriptyline, Novacaine, Olanzapine, Oxazepam, Penicillin, Perazine, Phencyclidine, Phenelzine, Phenobarbital, Pipothiazine, Pizotifen, Pramipexole, Prazepam, Pregabalin, Primidone, Prochlorperazine, Propiomazine, Propofol, Protriptyline, Quetiapine, Ramelteon, Reserpine, Ritalin, Sulfa antibiotics, Temazepam, Thiopentone, Tizanidine, Topiramate, Tricyclic antidepressants, Trifluperidol, Trimipramine, Ultram , Vigabatrin, Zaleplon, Ziconotide, Zolpidem, Zopiclone, Amitriptyline, Amoxapine, Antipsychotic agents, Barbiturates, Benzodiazepines, Bromazepam
Ear Nose Throat	No underlying causes
Endocrine	Diabetic ketoacidosis, Hyperosmolar non-ketotic diabetic coma, Hypothyroidism
Environmental	Heat stroke
Gastroenterologic	Hepatic failure, Variceal Bleeding
Genetic	Hereditary fructose-1-phosphate aldolase deficiency, Fumarase deficiency, Long chain hydroxyacyl-CoA dehydrogenase deficiency, Mitochondrial acetoacetyl-CoA thiolase deficiency, Unverricht-Lundborg disease, Progressive myoclonus epilepsy, Carbamoylphosphate synthetase 1 deficiency , Carnitine deficiency , Carnitine-acylcarnitine translocase deficiency
Hematologic	Anemia, Thrombotic thrombocytopenic purpura
Iatrogenic	Ureterosigmoidostomy
Infectious Disease	Malaria, Rabies, Sleeping sickness , Intracranial abscess, Meningoencephalitis
Musculoskeletal / Ortho	No underlying causes
Neurologic	Acute hemorrhagic leukoencephalitis, Alcohol withdrawal syndrome, Anencephaly, Brain death, Cataplexy, Epidural haemorrhage, Fits, Focal seizures, Intracranial abscess, Intracranial granuloma, Intracranial haemorrhage, Meningoencephalitis, Partial seizure, Pituitary apoplexy, Progressive myoclonus epilepsy, Raised intracranial pressure, Secondarily generalized seizure, Subarachnoid haemorrhage, Subdural haemorrhage, Syncope, Unverricht-Lundborg disease
Nutritional / Metabolic	Arginosuccinic aciduria, Carbamoylphosphate synthetase 1 deficiency , Carnitine deficiency , Carnitine-acylcarnitine translocase deficiency, Hypermagnesaemia, Hypoglycemia, Thiamine deficiency, Diabetic ketoacidosis, Hyperosmolar non-ketotic diabetic coma, Hereditary fructose-1-phosphate aldolase deficiency, Fumarase deficiency, Long chain hydroxyacyl-CoA dehydrogenase deficiency, Mitochondrial acetoacetyl-CoA thiolase deficiency
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Opthalmologic	No underlying causes
Overdose / Toxicity	Amitriptyline, Amoxapine, Antipsychotic agents, Barbiturates, Benzodiazepines, Bromazepam, Bupivacaine, Tetrahydrocannabinol, Buprenorphine, Buspirone, Chlophedianol, Chloral hydrate, Chlorpheniramine, Chlorpromazine, Cinnarizine, Clomipramine, Clonazepam, Clotiapine, Cocaine, Codeine, Cyclobenzaprine, Cycloserine, Dantrolene, Demerol , Demethyldiazepam, Deserpidine, ,Desipramine ,Diamorphine ,Diazepam ,Dichloralphenazone, Diphenhydramine, Diphenidol, Dothiepin, Doxepin , Efavirenz, Eszopiclone, Ethchlorvynol ,Flurazepam , Fluridrazepam, Gabapentin, Gamma hydroxybutyrate, Ganaxolone, General anaesthesia, Glutethimide, Haloperidol, Hydrazine, Hydroxyzine, Imipramine, Inhalational anaesthetics, Iron compounds, Levetiracetam, Levomepromazine, Lidocaine, Local anaesthetia, Lofexidine, Lorazepam, Medazepam, Melatonin, Mephenoxalone, Meprobamate, Methadone, Methaqualone, Methyldopa, Methyprylon, Metoclopramide, Mianserin, Midazolam, Mirtazapine, Morphine, Nabilone, Nitrazepam, Nitrous oxide, Nortriptyline, Novacaine, Olanzapine, Oxazepam, Penicillin, Perazine, Phencyclidine, Phenelzine, Phenobarbital, Pipothiazine, Pizotifen, Pramipexole, Prazepam, Pregabalin, Primidone, Prochlorperazine, Propiomazine, Propofol, Protriptyline, Quetiapine, Ramelteon, Reserpine, Ritalin, Sulfa antibiotics, Temazepam, Thiopentone, Tizanidine, Topiramate, Tricyclic antidepressants, Trifluperidol, Trimipramine, Ultram , Vigabatrin, Zaleplon, Ziconotide, Zolpidem, Zopiclone
Psychiatric	No underlying causes
Pulmonary	Airway obstruction, Anoxia, Asphyxiation, Pulmonary arteriovenous fistula
Renal / Electrolyte	Chronic renal failure, Acute renal failure
Rheum / Immune / Allergy	Acute hemorrhagic leukoencephalitis
Sexual	No underlying causes
Trauma	Acute spinal cord injury, Concussion, Electric shock, Fat embolism, Firearm Injury, Mild Traumatic Brain Injury, Near-drowning, Skull fracture, Epidural haemorrhage, Subdural haemorrhage
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Acute altitude sickness, Decompression sickness, Hyperbaric sickness, Hypothermia, Narcolepsy, Heat stroke, Alcohol withdrawal syndrome

Causes in Alphabetical Order

1,1-Dichloroethene 1,4-Dioxane 2,4-Dinitrotoluene 2-Methyl-4-Chlorophenoxyacetic Acid Acetone Acetophenone Acute hemorrhagic leukoencephalitis Acute spinal cord injury Acute varnish makers' and painters' Naptha Airway obstruction Alcohol withdrawal syndrome Allyl alcohol Allyl chloride Allyl trichloride Acute altitude sickness Aluminum phosphide Amidithion Amiton Amitriptyline Amoxapine Anemia Anencephaly Aniline Anoxia Antifreeze Antipsychotic agents Arginosuccinic aciduria Asphyxiation Athyl-Gusathion Atropine Azinophos-methyl Azinfos-ethyl Azinphosmetile Azothoate Baclofen Barbiturates Benoxafos Benzodiazepines Brain death Bromazepam Bromophos Bupivacaine Buprenorphine Buspirone Cadusafos Cannabinoids Carbamoylphosphate synthetase 1 deficiency Carbon monoxide Carbon tetrachloride Carbophenothion Cardiac arrest Carnitine deficiency Carnitine-acylcarnitine translocase deficiency Cataplexy Chlophedianol Chloral hydrate Chlorfenvinphos Chlorobenzene Chloropyrifos Chlorpheniramine Chlorpromazine Chlorpyrifos methyl Chronic renal failure Cinnarizine Claviceps purpurea Clomipramine Clonazepam Clotiapine Cocaine Codeine Concussion Cone shell Cyanides Cyanthoate Cyclobenzaprine Cyclohexanone Cycloserine Dantrolene Decompression sickness Demerol Demethyldiazepam Demeton Demeton-methyl Demeton-O Demeton-O-methyl Demeton-S-methyl Demeton-S-methylsulphon Deserpidine Desipramine Diabetic ketoacidosis Dialifos Diamorphine Diazepam Diazinon Dichloralphenazone Dichlorvos Dicrotophos Diethylene glycol Dimethoate Dimethyl phthalate Dioxathion Diphenhydramine Diphenidol Disulfoton Dothiepin Doxepin Earthball Efavirenz Electric shock

Endosulfan Endothion Epidural haemorrhage Eszopiclone Ethchlorvynol Ethinamate Ethion Ethoate-methyl Ethoprophos Ethyl mercaptan Ethylbenzene Ethyl-guthion Etrimfos Fat embolism Fenchlorphos Fenitrothion Fensulfothion Fenthion Firearm Injury Fits Flurazepam Fluridrazepam Focal seizures Fonophos Formothion Hereditary fructose-1-phosphate aldolase deficiency Fumarase deficiency Gabapentin Gamma hydroxybutyrate Ganaxolone General anaesthesia Glutethimide Guthion-ethyl Haloperidol Heat stroke Hepatic failure Heptenophos High melting explosive Hydrazine Hydroxyzine Hyperbaric sickness Hypermagnesaemia Hyperosmolar non-ketotic diabetic coma Hypoglycemia Hypothermia Hypothyroidism Imipramine Inhalational anaesthetics Insect allergy Intracranial abscess Intracranial granuloma Intracranial haemorrhage Iodofenphos Iron compounds Jet Fuel-4 Jet Fuel-8 Levetiracetam Levomepromazine Lidocaine Local anaesthetia Lofexidine Long chain hydroxyacyl-CoA dehydrogenase deficiency Lorazepam Malaria Malathion Mecarbam Medazepam Melatonin Meningoencephalitis Mephenoxalone Meprobamate Methacrifos Methadone Methamidophos Methane Methaqualone Methidathion Methiocarb Methomyl Methyl ethyl ketone Methyl mercaptan Methyl parathion Methyl tert-butyl ether Methyldopa Methylene Chloride Methyprylon Metiltriazotion Metoclopramide Mevinphos Mianserin Midazolam Mild Traumatic Brain Injury Mirtazapine Mitochondrial acetoacetyl-CoA thiolase deficiency Monocrotophos Morphine N,N-Dimethyl-P-Toluidine Nabilone Naphthalene Narcolepsy Near-drowning Nitrazepam Nitroethane Nitromethane Nitrophenol Nitrophenol Urea Nitrous oxide Nortriptyline

Novacaine Olanzapine Omethoate Oxazepam Oxydeprofos Oxydisulfoton Parathion Parathion Methyl Partial seizure Penicillin Pentaborane Pentachlorophenol Perazine Phencyclidine Phenelzine Phenkapton Phenobarbital Phorate Phosalone Phosdrin Phosmet Phosphamidon Phosphine Phoxim Pine oil Pipothiazine Pirimiphos-methyl Pituitary apoplexy Pizotifen Pramipexole Prazepam Pregabalin Primidone Primiphos methyl Prochlorperazine Profenofos Progressive myoclonus epilepsy Propiomazine Propofol Propylene glycol dinitrate Prothidathion Prothoate Protriptyline Pulmonary arteriovenous fistula Pyridine Pyrimitate Quetiapine Quinalphos Quintiofos Rabies Raised intracranial pressure Ramelteon RDX Acute renal failure Reserpine Ritalin Secondarily generalized seizure Selenium Shock Skull fracture Sleeping sickness Sodium azide Sodium hypochlorite Sophamide Stoddard solvent Subarachnoid haemorrhage Subdural haemorrhage Sulfa antibiotics Sulfotep Syncope Temazepam Terbufos Tetrachloroethylene Tetraethyl Pyrophosphate Tetrahydrocannabinol Tetrahydrofuran Thiamine deficiency Thiometon Thiopentone Thrombotic thrombocytopenic purpura Tizanidine Tolclofos methyl Toluene Topiramate Triazophos Triazotion Trichlorfon Trichloroethane Triclofos Tricyclic antidepressants Trifenfos Trifluperidol Trimipramine Ultram Unverricht-Lundborg disease Ureterosigmoidostomy Vamidothion Variceal Bleeding Ventricular fibrillation Vigabatrin Vinyl Choride Water hemlock poisoning Xylene Zaleplon Ziconotide Zinc Phosphide Zolpidem Zopiclone

Differentiating Loss of Consciousness from other Disorders

• Loss of consciousness should not be confused with the notion of the psychoanalytic unconscious or cognitive processes (e.g., implicit cognition) that take place outside of awareness. Loss of consciousness must not be confused with altered states of consciousness, such as delirium (when the person is confused and only partially responsive to the environment), normal sleep, hypnosis, and other altered states in which the person responds to stimuli.

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