Altered mental status

Revision as of 22:54, 7 November 2017 by Rossdonaldson1 (talk | contribs) (See Also)

This page is for adult altered mental status. See altered mental status (peds) for the pediatric page.


  • Alteration of arousal or content of consciousness or both
  • Both cerebral cortices or brainstem must be affected
  • Delirium vs dementia vs psych
  • Must quickly determine if coma is from diffuse or focal impairment

Clinical Features

  • Depends on cause
    • Diffuse brain dysfunction - lack of focal findings
    • Focal brain dysfunction - hemiparesis, loss of motor tone, loss of ocular reflexes

Differential Diagnosis

Altered mental status

Diffuse brain dysfunction

Primary CNS disease or trauma



AMS Workup

Common Orders

Consider Based on Clinical Situation


  • Patients with focal findings may have surgically treatable cause
  • Coma cocktail
  • Treat underlying cause


  • Most frequently admission, unless of a chronic and known etiology

See Also