Escolar Documentos
Profissional Documentos
Cultura Documentos
conscienceness
Shouye Zhao
Hepatobiliary Sugery Department
Abstract
Somnolence(Lethargy )
Confusion
Stupor
Coma
delirium
Definition
Lethargy (or somnolence): arousal, though
diminished, is maintained spontaneously or with
repeated light stimulation. weakness characterized by a
lack of vitality or energy
Stupor: severely impaired arousal with some
responsiveness to vigorous stimuli.;marginal
consciousness
Confusion: impaired attention and adequate arousal to
perform mental status tests of this ability. a mental state
characterized by a lack of clear and orderly thought and
behavior
Definition
Coma: total or near-total unresponsiveness. a state
of deep and often prolonged unconsciousness; usually
the result of disease or injury
Delirium: confusion with periods of agitation and
sometimes hypervigilance, active irritability, and
hallucinations, typically alternating with periods during
which the level of arousal is depressed. state of violent
mental agitation
Pathology and Etiology
Metabolic Encephalopathy
Substrate deprivation Poisoning
Hypoxia Alcohol
Diffuse ischemia Prescribed drugs
Hypoglycemia Poisons ---CO(carbon monoxide)
Vitamin deficiency Drug withdrawal
Systemic diseases Meningitis Encephalitis
Respiratory failure (hypercapnia) Subarachnoid hemorrhage
Kidney failure (uremia) Electrolyte disorders
Liver failure
Water, sodium, calcium, Mg, Al.
Acid-base disorders Concussion-
Endocrine dysfunction Thyroid contusion Seizures or postictal
Parathyroid Adrenal states Mixed metabolic
Pancreas encephalopathy Intensive care
Hypertensive encephalopathy unit delirium
Fever
Sepsis
Porphyria
Pathology and Etiology
Brain hernia
Brainstem injury
DIFFERENTIAL DIAGNOSIS OF COMA AND CONFUSION
AND EARLY DIAGNOSTIC TESTS