Altered sensorium

 1)  35 yr old male with sudden onse t seizures and altered sensorium since then ..on evaluation with multiple acute infarcts in brain with severe MS and AS. 

https://alekyatummala.blogspot.com/2020/08/35-male-with-sudden-onset-seizures.html?m=1


2)53/F - PCA stroke / ? IC bleed---SAH

K/c/o CRHD; severe calcific AS , Moderate LVD

Sx- AVR ( TTK - Chitra valve done in 2019).

K/c/o HTN since 2 yrs.

 http://budigammadhumithagm.blogspot.com/2021/07/53-y-old-female-with-neck-stiffness.html 


3) 30/M - altered state and sob - CKD uremic encphelapathy. https://alekyatummala.blogspot.com/2020/08/pulmonary-embolism.html?m=


4)26/M-  Hepatic encephalopathy with acute decompensated liver failure

Hypotension secondary to ? Sepsis 

Right heart failure

 https://nadipisneha.blogspot.com/2021/07/a-case-of-bl-pedal-edema-altered.html


5) Yellow phosphorus poisoning -29/F

https://karnativaishnavi.blogspot.com/2021/07/29-f-with-yellow-phosphorus-poisoning.html


6)Acute liver failure - hepatoc encephalopathy.-18/M

https://karnativaishnavi.blogspot.com/2021/07/medical--miracle-hello-everyone-this-is.html


7) 50 yr old DKA ,POST nephrectomy - ?mucor  -MALE

https://medicalelog82.blogspot.com/2021/08/dka-post-nephrectomy.html.


8) 50 yr old with dysphagia and altered sensorium. - uremic encphelapathy,aki ,? Mucor .; Uncontrolled sugars.-MALE -

https://rambai123.blogspot.com/2021/05/50-year-old-male-patient-with-history.html


9) 65 M - uti and hyponatremia. 

http://sriramkk2k.blogspot.com/2021/08/65m-with-uti-with-aki-with-hyponatremia.html


10) Dka with aki and hypoxic brain injury. -35/F -MULTIFACTORIAL

https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.html?m=1


11) Hepatic Encephalopathy/ infective endocarditis. -52/M

https://pallavi191.blogspot.com/2021/06/gm-cases_30.html?m=1.


12) Chronic decompensated liver disease.- 35/M

https://ratnashivani08.blogspot.com/2021/06/medicine-case-discussion.html?m=1. 


13)65 /M - snake bite - uremia - https://achalram1512.blogspot.com/2021/08/admission-65-year-old-male-from.html


14)  26 F - hyponatremia, Tb meningitis, left thalamic infarct.-26 F-MULTIFACTORIAL

https://harikachindam7.blogspot.com/2020/12/26-year-old-female-with-complaints-of.html?m=1


15) ckd and septic encephalopathy later - bilateral lung cavities; echymosis ; (?wegners) -38F

https://ashiness92.blogspot.com/2020/07/38-year-old-woman-currently-on.html?m=1 -UREMIC


16)altered state secondary to cva. -CNS

https://deekshitha44medicinelogbook.blogspot.com/2021/09/67-year-old-female.html.




17) Ckd / metabolic acidosis/ uremic encphelapathy -M

https://karnativaishnavi.blogspot.com/2021/01/ckd.html?m=1.


18) 62 old with hypoglycemia -F

http://zuberiasanya.blogspot.com/2020/08/a-62-year-old-female-sweeper-by.html.


19) Dka - rt 3,4 toe amputation -male.

https://vineelashambhavi.blogspot.com/2020/08/56-year-old-man-with-diabetic.html?m=1.


20) 65 yr old female with vomitings,decreased urine output.-DKA

https://zuberiasanya.blogspot.com/2020/09/a-72-yr-old-female-who-is-vegetable.html?m=1


21) 41 yr old male with alcohol withdrawal-? Wernickes encphelapathy. -METABOLIC

https://spandanatippireddy.blogspot.com/2020/09/a-41y-old-man-with-acute-pancreatitis.html?m=1


22)  Ckd on MHD - hfref and pneumonia- 70 M -

https://asrithareddy10.blogspot.com/2020/12/is-online-e-log-book-to-discuss-our_31.html?m=1


23) 45 F with portal htn , cirrhosis -HCV REACTIVE.

https://asrithareddy10.blogspot.com/2021/01/is-online-e-log-book-to-discuss-our_11.html?m=1


24) 45 M with alcoholic liver disease and hepatic encphelapathy.

https://harshinireddy999.blogspot.com/2020/12/45-year-old-male-patientworking-as_25.html?m=1


25) 45 M with decompensated liver disease , hepatic encphelapathy. https://pravalikachithanuri.blogspot.com/2020/10/45-year-old-male-with-decompensated.html?m=1


26) 70 M with decompensated liver disease and hepatic encephalalopathy.

https://sairaghuver.blogspot.com/2020/10/is-online-e-log-book-to-discuss-our.html?m=1 


27) 57 Male with cld and hepatic encephalalopathy

https://swathibogari158.blogspot.com/2020/09/chronic-decompensated-liver-disease.html?m=1

28) 27/M  

Alcohol induced gastritis
 with K/C/O delirium tremens and alcohol dependent syndrome

https://himabindu5.blogspot.com/2020/05/medicine-case-presentation.html?m=1


29) 85 Y old female with left upper limb and lower limb weakness .

https://alekyatummala.blogspot.com/2020/08/cva.html.


30) ) case of 20 yr old male with Complaints of right upperlimb  involuntary movements with secondary generalization of bilateral upper and limbs .  - seizures . On presentation no altered sensorium.

https://supraja97.blogspot.com/2020/08/seizures-case.html 

 

31) Patient came with the complaint of generalised tonic clonic type of seizure(1 episode) - seizures - uremic encphelapathy - female 40 yrs. -MULTIFACTORIAL

https://sreejapoli.blogspot.com/2020/06/hello-everyone-iam-intern-in-medicine.html?m=1


32) Stroke 

67 yr old male with Left hemiplegia and slurred speech.

https://sindhusailajav.blogspot.com/2020/08/67-yr-old-man-with-left-sided.html?m=1


33)Hypoglycemia mimicking stroke. -65/F -METABOLIC

https://shivanibhashyam.blogspot.com/2020/08/65-year-old-woman-with-recurrent.html?m=1

34) 45 yr old male with left hemiparesis.-CVA

https://vineelashambhavi.blogspot.com/2020/09/45-hear-old-man-with-recurrent-syncopal.html?m=1


35)65 me with left side weakness -CVA

https://zuberiasanya.blogspot.com/2020/08/65-year-old-man-presented-to-opd-with-2.html


36)65 yr old with visual hallucinations , irrelevant talk. -

https://apoorvagoli.blogspot.com/2020/11/a-65year-old-male-patient-with-delerium.html?m=1. 


37))  Dr Rishi - intern 2015

34 yr old male with right side weakness -CVA

https://priyankadevarapalli.blogspot.com/2021/01/old-man-as-working-driver-presented-in.html?m=1


38) 28 M - death - mods /hepatic encphelapathy.

https://nadipisneha.blogspot.com/2021/07/a-case-of-bl-pedal-edema-altered.html


39)63 yr old FEMALE with weakness and altered sensorium ( hyponatremia) 

https://rishidandaboiena63.blogspot.com/2020/12/a-63-year-old-presented-with-weakness.html?m=1


40) 23 yr old female with meningitis (?TB /? Bacterial) with absent seizures .

https://salonibharadia20.blogspot.com/2020/10/this-is-online-e-log-book-to-discuss.html?m=1


41) 

30 yr old male with alcohol withdrawal seizures

https://sruthichintha.blogspot.com/2020/10/a-30year-old-male-with-alcoholic.html?m=1

42)

65 yr old M with seizures

https://pamardeepika24.blogspot.com/2020/09/65-yr-old-male-with-acute-onset-of.html?m=1


 43)58 yr old male with acute hemorrhagic stroke

https://sushma29.blogspot.com/2020/10/acute-hemorrhagic-strokert-sided.html?m=1


44) 65  male with recurrent CVA and visual hallucinations and old pulmonary kochs.

https://drkulkarnithesis.blogspot.com/2020/10/65m-with-recurrent-cva-with-visual.html?m=1


45)30 yr old with seizures.

https://meghanabonaboina.blogspot.com/2020/10/a-30-year-old-lady-with-known-case-of.html?m=1


46) 65/M 

ALTERED SENSORIUM UNDER EVALUATION

SECONDARY TO ALCOHOLIC INTOXICATION, UTI, PNEUMONIA

? ACUTE VIRAL HEPATITIS( HCV) -MULTIFACTORIAL

https://jancykoneti79.blogspot.com/2021/08/a-60-year-old-male-with-altered.html?m=1.


47)  65yr old man , farmer by occupation came with complaints of  involuntary movements of bilateral upper and lower limbs lasting for about 3 to 5 minutes.- SEIZURES.

https://vsupriyareddy35.blogspot.com/2020/08/65yr-old-man-case.html?m=1

48) 23/m -ACUTE INFARCT.

 https://vsupriyareddy35.blogspot.com/2020/09/23yr-old-acute-infarct.html?m=1


49) Tb meningitis -45/M

 https://keerthireddy42.blogspot.com/2021/07/a-45-yr-old-male-is-chronic-alcoholic.html

50) 59/M- Hepatic Encephalopathy.

http://katanaveenkumar.blogspot.com/2021/08/59-old-male-came-to-casuality-with.html.

51)45/M-  AKI , SEPSIS AND HYPONATREMIA. https://sridevi0090.blogspot.com/2020/09/sridevis-e-log.html?m=1 - MULTIFACTORIAL.


52) 60/M - with hyponatremia and ulcers.-METABOLIC

https://vsupriyareddy35.blogspot.com/2020/09/60yr-old.html?m=1.

53) 45 year old with seizures secondary to hepatic encephalopathy with alcoholic delirium and withdrawal and thrombocytopenia - 

https://jayanth1802.blogspot.com/2021/02/45-year-old-with-seizures-secondary-to.html?m=1


54) A 46 year old male patient with SEVERE METABOLIC ACIDOSIS (RESOLVED) SECONDARY TO ? STARVATION KETO ACIDOSIS ? ALCOHOLIC KETO ACIDOSIS RIGHT HEART FAILURE SECONDARY TO ? WET BERI BERI (RESOLVING) - METABOLIC .

Pr presented with tachypneia and hypotension (60-sbp) , altered - /?MULTIFACTORIAL.

https://deepthithunga1998.blogspot.com/2021/05/a-46-year-old-male-patient-with-severe.html?m=1.


55)50/F - recurrent hypoglycemia- nephrotic synd.-ENDOCRINE

 https://sowmya9.blogspot.com/2021/08/50-year-old-female-with-recurrent.html?m=1


56) 75 /m - altered sensorium secondary to hanging/ tb menigitis - death. - Hypoxic brain injury - CNS CAUSE /

https://rollno52.blogspot.com/2021/06/75-year-old-with-altered-sensorium.html?m=1.


57) 45/F - seizures. 

https://srivani187.blogspot.com/2021/06/a-45-year-old-female-with-seizures.html?m=1


58) 48/male - ? Meningo encpheliltis  https://siddarth43.blogspot.com/2021/06/gm-post-op.html?m=1.

 

59)48 M - hepatic encphelapathy

https://manasa71.blogspot.com/2021/08/a-48-year-old-male.html?m=1.



60) 60f  -lung mass / altered sensorium - mixed cause ( sepsis/resp failure-acidosis /aki )-TAKE SEPSIS.

 https://pallavi191.blogspot.com/2021/08/gm-cases.html?m=1

 

61)Uremic encphelapathy:  75/M

https://selinakm89.blogspot.com/2021/08/uremic-encephalopathy-with-aki-on-ckd.html.


62)Emphsematous pyelonephritis - layer altered.- 45 F -  https://karnativaishnavi.blogspot.com/2020/06/hello-everyone.html?m=1








NTRODUCTION

Altered mental status (AMS) comprises a group of

clinical symptoms rather than a specific diagnosis, and

includes cognitive disorders, attention disorders, arousal

disorders, and decreased level of consciousness.[1] AMS is

a very common emergency case, but the exact etiology of

many AMS patients is unknown. Patients often manifest

vague symptoms, thus, AMS diagnosis and treatment

are highly challenging for emergency physicians. An

in-depth understanding of the pathogenesis of AMS

and complete patient assessment will help increase the

diagnosis rate and ensure treatment accuracy.

In conclusion, a systematic analysis of acute AMS

patients reveals that the common causes of AMS are

primary neurological factors, drug and poisoning,

system/organ dysfunction, and metabolic and endocrine

factors. The etiology of AMS is significantly different

in various age groups. The reversibility of diseases and

the potentially fatal factors associated with AMS require

timely assessment and rapid intervention for the potential












references:

1) American College of Emergency Physicians. Clinical policy for the initial approach to patients presenting with altered mental status. Ann Emerg Med 1999; 33: 251–280.

 2 Kekec Z, Senol V, Koc F, Seydaoglu G. Analysis of altered mental status in Turkey. Int J Neurosci 2008; 118: 609–617. 

 3.Storm-Versloot MN, Ubbink DT, Kappelhof J, Luitse JS. Comparison of an informally structured triage system, the emergency severity index, and the manchester triage system to distinguish patient priority in the emergency department. Acad Emerg Med 2011; 18: 822–829.

4.Kanich W, Brady WJ, Huff JS, et al. Altered mental status: evaluation and etiology in the ED. Am J Emerg Med 2002;20(7):613-617.

 5. Hustey FM, Meldon SW. The prevalence and documentation of impaired mental status in elderly emergency department patients. Ann Emerg Med 2002;39(3):248-253


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