Altered mental status causes

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

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

• Carbon monoxide toxicity
• Heat stroke
• Hypothermia
• Malignant hypertension
• Myocardial infarction
• Rabies
• Sepsis

Common Causes

• Alcohol withdrawal
• Drug withdrawal
• Dehydration
• Electrolyte disturbance
• Encephalitis
• Epileptic seizures
• Hyperglycemia
• Hypoglycemia
• Meningitis
• Sepsis

Causes by Organ System

Cardiovascular	Malignant hypertension, Heart failure, Myocardial infarction, Congestive heart failure, Ventricular arrhythmia
Chemical/Poisoning	Withdrawal states from ethanol, benzodiazepines,Water hemlock poisoning, Toxic mushrooms -- Monomethylhydrazine ,Toluene, Texas Mescalbean poisoning,Poison hemlock, Organic solvent, Methanol , Marijuana, Lead, Jimson weed, Hyperbaric sickness, Hydrogen sulfide , Heroin ,Hallucinogens, Ethylene glycol, Ethanol, Daphne poisoning, Cyanide, Carbon tetrachloride, Carbon monoxide toxicity, Alcohol withdrawal, Thallium Sulfate poisoning,Phencyclidine poisoning, Nickel, Carbonyl poisoning
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Acyclovir, Alfentanil, Alphaprodine, Amantadine, Amiloride, Aminoglycosides, Aminophylline, Amitriptyline, AmlodipineAmobarbitalAmphetamine, Amphotericin B, AnalgesicsAntiarrhythmics, 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, 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, EszopicloneEthosuximide, Ethotoin, Ethylmorphine, Fentanyl, Fludarabine, Fluoroquinolones, gabapentinGeneral 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, Nonsteroidal anti-inflammatory drugs, Norfloxacin, Norpropoxyphene, Nortriptyline, Noscapine, olanzapine, Opiates, Opium, Nitrazepam, 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, Sulfonamidesthioridazine, tricyclic antidepressants,Zaleplon, ziprasidone zolpidem, zopiclone
Ear Nose Throat	Burns, chester porphyria, decompression sickness, porphyria
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	Hypothermia, hyperthermia, heat stroke, electric shock, decompression sickness, acute Altitude sickness
Gastroenterologic	Acute diverticulitis, Acute Liver failure, Appendicitis, carcinoid crisis , Chronic liver failure, Chronic Liver failure, Cirrhosis of liver, Constipation Elevated or depressed pancreas function, 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, Folate deficiency, Hypovolemia, Internal bleeding, Hypercoagulable state, Hypereosinophilia, Leukostasis, Methemoglobinemia, Polycythemia,Porphyria, Prothrombotic state, Pulmonary embolism, Severe hemorrhage
Iatrogenic	Neuroleptic malignant syndrome, serotonin syndrome
Infectious Disease	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, Intraspinal abscess / granuloma, Intracranial abscess / granuloma, Gangrene , Chest infection, Cerebral malaria,Brain or epidural abscess, Brain infection, Infectious mononucleosis (glandular fever), Lyme disease
Musculoskeletal/Orthopedic	Fibromyalgia
Neurologic	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, Brain edema, Cerebral hypoxia, Hydrocephalus
Nutritional/Metabolic	Wilson's disease, Wernicke's encephalopathy, Vitamin B12 deficiency, Thiamine (Vitamin B1) deficiency, Niacin deficiencies, Folate deficiency, Acute intermittent porphyria, Starvation
Obstetric/Gynecologic	Eclampsia, hyperoestrogenic states, preeclampsia
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	Advanced sleep phase disorder, anxiety state, bipolar disorder, brief psychotic disorder, catatonia, chronic fatigue syndrome, delayed sleep phase syndrome, dementia, depression, drug abuse, hysteria, 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
Renal/Electrolyte	Hypophosphatemia, hypoosmolar states, Hyponatremia, Hypocalcemia, Hyperosmolar states, Hypernatremia, Hypermagnesemia, Hypercalcemia, Hypomagnesemia, Hyperphosphatemia, Chronic Renal failure, Acute Renal failure, Uremia, Dehydration
Rheumatology/Immunology/Allergy	Vasculitis
Sexual	No underlying causes
Trauma	Trauma, Skull fracture, Head injury
Urologic	Urinary Track Infection
Miscellaneous	Coproporphyria, Burns, Chronic fatigue syndrome

Causes in Alphabetical Order

The unnamed parameter 2= is no longer supported. Please see the documentation for {{columns-list}}.

4