{"title":"Diagnostic Approach to the Patient with Altered Mental Status.","authors":"Ori J Lieberman, Aaron L Berkowitz","doi":"10.1055/s-0044-1791245","DOIUrl":null,"url":null,"abstract":"<p><p>Acute encephalopathy is a common presenting symptom in the emergency room and complicates many hospital and intensive care unit admissions. The evaluation of patients with encephalopathy poses several challenges: limited history and examination due to the patient's mental status, broad differential diagnosis of systemic and neurologic etiologies, low yield of neurodiagnostic testing due to the high base rate of systemic causes, and the importance of identifying less common neurologic causes of encephalopathy that can be life-threatening if not identified and treated. This article discusses the differential diagnosis of acute encephalopathy, presents an approach to the history and examination in a patient with encephalopathy, reviews the literature on the yield of neurodiagnostic testing in this population, and provides a diagnostic framework for the evaluation of patients with altered mental status.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":"579-605"},"PeriodicalIF":1.8000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/s-0044-1791245","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/1 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Acute encephalopathy is a common presenting symptom in the emergency room and complicates many hospital and intensive care unit admissions. The evaluation of patients with encephalopathy poses several challenges: limited history and examination due to the patient's mental status, broad differential diagnosis of systemic and neurologic etiologies, low yield of neurodiagnostic testing due to the high base rate of systemic causes, and the importance of identifying less common neurologic causes of encephalopathy that can be life-threatening if not identified and treated. This article discusses the differential diagnosis of acute encephalopathy, presents an approach to the history and examination in a patient with encephalopathy, reviews the literature on the yield of neurodiagnostic testing in this population, and provides a diagnostic framework for the evaluation of patients with altered mental status.
期刊介绍：
Seminars in Neurology is a review journal on current trends in the evaluation, diagnosis, and treatment of neurological diseases. Areas of coverage include multiple sclerosis, central nervous system infections, muscular dystrophy, neuro-immunology, spinal disorders, strokes, epilepsy, motor neuron diseases, movement disorders, higher cortical function, neuro-genetics and neuro-ophthamology. Each issue is presented under the direction of an expert guest editor, and invited contributors focus on a single, high-interest clinical topic.
Up-to-the-minute coverage of the latest information in the field makes this journal an invaluable resource for neurologists and residents.
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