Template:AMS DDX

Altered mental status

1. Diffuse brain dysfunction
   1. Encephalopathies
      1. Hypoxic encephalopathy
      2. Metabolic encephalopathy
         1. Hypoglycemia
         2. Hyperosmolar state (e.g., hyperglycemia)
         3. Electrolyte Abnormalities (hypernatremia or hyponatremia, hypercalcemia)
         4. Organ system failure
         5. Hepatic Encephalopathy
         6. Uremia/Renal Failure
         7. Endocrine (Addison disease, hypothyroidism)
         8. Hypoxia
         9. CO2 narcosis
      3. Hypertensive Encephalopathy
   2. Toxins
   3. Drug reactions (NMS)
   4. Environmental causes
      1. Hypothermia
      2. Hyperthermia
   5. Deficiency state
      1. Wernicke encephalopathy
   6. Sepsis
2. Primary CNS disease or trauma
   1. Direct CNS trauma
      1. Diffuse axonal injury
      2. Subdural/epidural hematoma
   2. Vascular disease
      1. Intraparenchymal hemorrhage
   3. SAH
   4. Infarction
      1. Hemispheric, brainstem
   5. CNS infections
   6. Neoplasms
   7. Seizures
      1. Nonconvulsive status epilepticus
         1. Consider if motor activity of seizure has stopped but pt is not alert w/in 30min
      2. Postictal state