Stupor: Difference between revisions
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| '''Infectious Disease''' | | '''Infectious Disease''' | ||
|bgcolor="Beige"| Infection involving the brain | |bgcolor="Beige"| Infection involving the brain ([[brain abscess]], [[meningitis]]), an infection complicated by [[sepsis]] | ||
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In alphabetical order: | In alphabetical order: | ||
*[[Alcohol abuse]] | *[[Alcohol abuse]] | ||
*[[Alzheimer's disease]] | |||
*[[Anticonvulsants]] | *[[Anticonvulsants]] | ||
*[[Antidepressants]] | *[[Antidepressants]] | ||
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*[[Anxiolytics]] | *[[Anxiolytics]] | ||
*[[Arrhythmias]] such as [[heart block]] | *[[Arrhythmias]] such as [[heart block]] | ||
*[[Brain abscess]] | |||
*[[Brain tumor]] | *[[Brain tumor]] | ||
*[[Cardiogenic shock]] | *[[Cardiogenic shock]] | ||
*[[Congestive heart failure]] | *[[Congestive heart failure]] | ||
*[[Dementia]] | |||
*[[Major depressive disorder|Depression]] | *[[Major depressive disorder|Depression]] | ||
*[[Heat stroke]] | *[[Heat stroke]] | ||
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*[[Infectious disease]]s, complicated by [[sepsis]] | *[[Infectious disease]]s, complicated by [[sepsis]] | ||
*Lesions of the [[Reticular activating system|Ascending Reticular Activation System]] on height of the [[pons]] and [[metencephalon]] have been shown to cause stupor. The incidence is higher after left-sided [[lesion]]s. | *Lesions of the [[Reticular activating system|Ascending Reticular Activation System]] on height of the [[pons]] and [[metencephalon]] have been shown to cause stupor. The incidence is higher after left-sided [[lesion]]s. | ||
*[[Liver failure]] | |||
*[[LSD]] | *[[LSD]] | ||
*[[Meningitis]] | |||
*[[Mental illness]] | *[[Mental illness]] | ||
*[[Narcotics]] | *[[Narcotics]] | ||
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*[[Opiates]] | *[[Opiates]] | ||
*[[Renal insufficiency]] | *[[Renal insufficiency]] | ||
*[[Seizure]] | |||
*[[Sedatives]] | *[[Sedatives]] | ||
*[[Schizophrenia]] | *[[Schizophrenia]] | ||
*[[Stroke]] | |||
*[[Vitamin D deficiency]] | *[[Vitamin D deficiency]] | ||
Revision as of 18:12, 6 August 2011
For patient information, click here
| Stupor |
Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Stupor is the lack of critical cognitive function and level of consciousness wherein a sufferer is almost entirely unresponsive and only responds to base stimuli such as pain. akinesis and mutism are present but with relative preservation of conscious awareness. A person is also rigid and mute and only appears to be conscious as the eyes are open and follow surrounding objects (Gelder, Mayou and Geddes 2005).
Historical Perspective
The word derives from the Latin stupure, meaning insensible.[1]
Differential Diagnosis of Underlying Causes
By organ system:
| Cardiovascular | Arrhythmias such as heart block, Cardiogenic shock, Congestive heart failure, hypertensive crisis, hypotension |
| Chemical / poisoning | Alcohol abuse, heavy metals, hydrocarbons |
| Dermatologic | No underlying causes |
| Drug Side Effect | Anxiolytics, antidepressants, antipsychotics, anticonvulsants, LSD, narcotics, opiates, sedatives |
| Ear Nose Throat | No underlying causes |
| Endocrine | Hyperglycemia, hyperthyroidism, hypoglycemia, hypothyroidism |
| Environmental | Heavy metals, hypothermia |
| Gastroenterologic | Liver failure |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | Overdose of anxiolytics, antidepressants, antipsychotics, anticonvulsants, narcotics, opiates, sedatives |
| Infectious Disease | Infection involving the brain (brain abscess, meningitis), an infection complicated by sepsis |
| Musculoskeletal / Ortho | No underlying causes |
| Neurologic | Alzheimer's disease, dementia, Lesions of the Ascending Reticular Activation System on height of the pons and metencephalon have been shown to cause stupor. The incidence is higher after left-sided lesions, seizure, stroke |
| Nutritional / Metabolic | Vitamin D deficiency |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | Brain tumor |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | Alcohol abuse, narcotics, opiates, sedatives |
| Psychiatric | conversion disorder, depression, extreme fatigue, schizophrenia |
| Pulmonary | COPD, hypercarbia, hypoxia due to a wide variety of lung diseases, |
| Renal / Electrolyte | Hypercalcemia, hyponatremia, renal insufficiency (acute and chronic) |
| Rheum / Immune / Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | Heat stroke, hypothermia, near drowning |
| Urologic | No underlying causes |
| Miscellaneous | No underlying causes |
In alphabetical order:
- Alcohol abuse
- Alzheimer's disease
- Anticonvulsants
- Antidepressants
- Antipsychotics
- Anxiolytics
- Arrhythmias such as heart block
- Brain abscess
- Brain tumor
- Cardiogenic shock
- Congestive heart failure
- Dementia
- Depression
- Heat stroke
- Heavy metals
- Hydrocarbons
- Hypercalcemia
- Hyperglycemia
- Hypertensive crisis
- Hypertensive encephalopathy
- Hyperthyroidism
- Hypoglycemia
- Hyponatremia
- Hypotension
- Hypothermia
- Hypothyroidism
- Infectious diseases, complicated by sepsis
- Lesions of the Ascending Reticular Activation System on height of the pons and metencephalon have been shown to cause stupor. The incidence is higher after left-sided lesions.
- Liver failure
- LSD
- Meningitis
- Mental illness
- Narcotics
- Near drowning
- Opiates
- Renal insufficiency
- Seizure
- Sedatives
- Schizophrenia
- Stroke
- Vitamin D deficiency
Differentiating stupor from other conditions
Stupor is not the same thing as a coma or a vegetative state. For example, some people who become injured suddenly with a concussion or some other cognitive impairment resulting from injury enter a stupor, where they are partially aware of their surroundings, or they become unconscious until they are revived by themselves or by others. This is often[citation needed] mistaken for delirium and treated with Haldol and or other anti-psychotic drugs.
Diagnosis
Symptoms
If not stimulated externally, a patient with stupor will be in a sleepy mode most of the time. In some extreme cases of severe depressive disorders the patient can become motionless, lose their appetite and become mute. Short periods of restricted responsivity can be achieved by intense stimulation (e.g. pain, bright light, loud noise).
CT Findings
Lesions of the Ascending Reticular Activation System on height of the pons and metencephalon have been shown to cause stupor. The incidence is higher after left-sided lesions.
See also
References
- ↑ Berrios G E (1981) Stupor: A Conceptual History. Psychological Medicine 11: 677-688
Template:Cognition, perception, emotional state and behaviour symptoms and signs
Template:Skin and subcutaneous tissue symptoms and signs Template:Nervous and musculoskeletal system symptoms and signs Template:Urinary system symptoms and signs Template:Cognition, perception, emotional state and behaviour symptoms and signs Template:Speech and voice symptoms and signs Template:General symptoms and signs