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Is the amnesia transient or persistent? If it is transient, one should look for evidence of a head injury. If there is no evidence of a head injury, then one should consider epilepsy, transient ischemic attacks, ... DIAGNOSTIC WORKUP
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Is there associated fever? Delirium with fever may simply indicate a self-limited infectious process, but it should bring to mind encephalitis and meningitis as well as cerebral abscess and cerebral hemorrhage.
Is there a history of ... DIAGNOSTIC WORKUP
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Is there a history of drug or alcohol ingestion? Hallucinations are common during alcohol withdrawal but also may be noted in cocaine addiction, marijuana addiction, LSD intoxication, and PCP intoxication.
Are the hallucinations primarily ... DIAGNOSTIC WORKUP
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Is there a history of drug or alcohol ingestion? Chronic barbiturate intoxication, ergotism, and other psychotropic or antidepressant drugs may cause dementia. Alcoholism may cause dementia in the form of Korsakoff's ... DIAGNOSTIC WORKUP
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Is it intermittent? Episodic aphasia, apraxia, or agnosia would suggest epilepsy, transient ischemic attacks, migraine, or hypertensive encephalopathy.
Is it acute or gradual in onset? Acute onset of aphasia, ... DIAGNOSTIC WORKUP
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Amnesia is an inability to remember prior events and process new information despite a normal level of consciousness. The memory center in the brain is housed in the temporal lobes; thus, the development of true amnesia requires pathology of both temporal lobes. The most common cause of... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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An acute confusional state caused by a disturbance in global cortical function. Features include disturbance of consciousness, change in cognition, fluctuations of symptoms, and evidence that the condition is secondary to an underlying medical... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Hallucinations are psychotic symptoms in which patients perceive stimuli that do not exist. Any of the five senses (auditory, visual, tactile, gustatory, or olfactory) may be involved, with auditory hallucinations being the most common. Patients may believe... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Dementia is a syndrome of premature neuronal death in focal brain regions. More than 50 illnesses may cause dementia. It affects 1% of the population by age 60, and this prevalence doubles every 5 years to reach 30–50% by age 85. Common... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Delirium is an alteration in consciousness that can be associated with hallucinations, disorientation, and delusions. Normal thought processes are altered, including judgment, and rational behavior may be lost. Causes are typically metabolic derangements, acute... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Hallucinations are defined as perceptual experiences that do not occur in reality. They may be auditory (most common), visual, tactile, or olfactory.
Differential Diagnosis
... Workup and Diagnosis ... Treatment
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... The most common causes of this disorder are head injury, epilepsy, migraine, drug use, and hysteria. However, it is wise to have a systematic method of remembering the many etiologies to avoid mistakes in diagnosis. The mnemonic VINDICATE provides an excellent
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... The differential diagnosis of delirium is very similar to that for coma and one finds the mnemonic VINDICATE useful in this regard.
V—Vascular disorders of the brain including hemorrhage, embolism, thrombosis, and arteriosclerosis may cause delirium.
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... A hallucination is seeing, hearing, touching, smelling, or tasting something that is not there. Auditory hallucinations without evidence of mental deterioration usually indicate schizophrenia, but epilepsy, drug toxicity, and brain tumors must be
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... Memory loss is a real symptom and sign, but organic brain syndrome should be dropped from usage because it is a wastebasket term. Unless the memory loss is functional (“supratentorial"), the cerebrum is the principal anatomic site of diseases that produce memory loss.
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... Amnesia — a disturbance in, or loss of, memory — may be classified as partial or complete and as anterograde or retrograde. Anterograde amnesia denotes memory loss of events that occurred after the onset of the causative trauma... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... An umbrella term for puzzling or inappropriate behavior or responses, confusion is the inability to think quickly and coherently. Depending on the cause, it may arise suddenly or gradually and may be temporary or irreversible. Aggravated by stress and sensory deprivation,... History and physical examination ... Medical causes ... Other causes ... Special considerations
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... A decrease in the level of consciousness (LOC), from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such as hemorrhage, trauma, or cerebral edema. However, this sign can also result from a metabolic, GI,... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Degenerative diseases
Alzheimer's disease
Cerebral arteriosclerosis, multiple cerebrovascular accidents
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... The essential feature of dissociative amnesia is a sudden inability to recall important personal information that can’t be explained by ordinary forgetfulness. The patient typically is unable to recall all events that occurred during a specific period, but other types of recall... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Amnesia—a disturbance in, or loss of, memory—may be classified as partial or complete and as anterograde or retrograde. Anterograde amnesia denotes memory loss for events that occurred after the onset of the causative trauma or disease; retrograde amnesia,... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Apraxia is the inability to perform purposeful movements in the absence of significant weakness, sensory loss, poor coordination, or lack of comprehension or motivation. This neurologic sign usually indicates a lesion in the cerebral hemisphere. Its onset, severity, and... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... An umbrella term for puzzling or inappropriate behavior or responses, confusion is the inability to think quickly and coherently. Depending on its cause, confusion may arise suddenly or gradually and may be temporary or irreversible. Aggravated by stress and sensory deprivation... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... A decrease in level of consciousness (LOC), from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such as hemorrhage, trauma, or cerebral edema. However, this sign can also result from a metabolic, GI,... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Mark W. Nickels
Acute confusional states represent an etiologically diverse spectrum of disorders that may involve alterations in thinking, perception, memory, orientation, or attention. In addition, present may be physiologic changes, alterations in sleep&ndash... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Linda P. Shields
Delirium, as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criterion (1), is a condition involving an acute confusional state recognized by the patient’s change in... Approach. ... History ... Physical examination. ... Testing ... Diagnostic assessment.
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... Anne Cather Cutlip
Dementia is characterized by a progressive cognitive decline leading to social or occupational disability occurring in a state of clear consciousness. It has an age-dependent epidemiology, occurring in... Approach. ... History. ... Physical examination. ... Testing ... Diagnostic assessment.
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... Differential Overview
❑ Concussion
❑ Alzheimer disease
❑ Drugs
❑ Generalized seizure
❑... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Alzheimer disease
❑ Multi-infarct dementia
❑ Depression
❑ Drugs
❑ ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Systemic
❑ Drugs/toxins
❑ Sepsis
❑ Hypoglycemia
❑ Hypercalcemia
... Diagnostic Approach ... Clinical Findings ... Pictures
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... Apraxia is the inability to perform purposeful movements in the absence of significant weakness, sensory loss, poor coordination, or lack of comprehension or motivation. Apraxia usually indicates a lesion in the cerebral hemisphere. Its onset, severity, and duration vary. ... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... A decrease in level of consciousness (LOC), from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such as hemorrhage, trauma, or cerebral edema. However, this sign can also result from a metabolic, GI,... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Apraxia is the inability to perform purposeful movements in the absence of significant weakness, sensory loss, poor coordination, or lack of comprehension or motivation. This neurologic sign usually indicates a lesion in the cerebral hemisphere. Its onset, severity, and duration... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... An umbrella term for puzzling or inappropriate behavior or responses, confusion is the inability to think quickly and coherently. Depending on its cause, confusion may arise suddenly or gradually and may be temporary or irreversible.... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A decrease in level of consciousness (LOC), which can range from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such as hemorrhage, trauma, or cerebral edema. However, this sign can also result from... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Amnesia—a disturbance in, or loss of, memory—may be classified as partial or complete and as anterograde or retrograde. Anterograde amnesiadenotes memory loss of events that occurred after the onset of the causative trauma or disease; retrograde amnesia,... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... An umbrella term for puzzling or inappropriate behavior or responses, confusion is the inability to think quickly and coherently. Depending on the cause, it may arise suddenly or gradually and may be temporary or irreversible. Aggravated by... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... A decrease in the level of consciousness (LOC), from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such as hemorrhage, trauma, or cerebral edema. However, this sign can also result from a metabolic, GI,... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
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The most common causes of this disorder are head injury, epilepsy,
migraine, drug use, and hysteria. However, it is wise to have a systematic
method of remembering the many etiologies to avoid mistakes in diagnosis.
The mnemonic VINDICATE provides an excellent
... READ EXCERPTS »
...
The differential diagnosis of delirium is very similar to that for
coma, and one finds the mnemonic VINDICATE useful in this regard.
V—Vascular disorders of the brain including hemorrhage, embolism,
thrombosis, and
... READ EXCERPTS »
...
A hallucination is seeing, hearing, touching, smelling, or tasting
something that is not there. Auditory hallucinations without evidence of
mental deterioration usually indicate schizophrenia, but epilepsy, drug
toxicity, and brain tumors must be excluded.
... READ EXCERPTS »
...
Memory loss is a real symptom and sign, but organic brain syndrome
should be dropped from usage because it is a wastebasket term. Unless the
memory loss is functional (“supratentorial”), the cerebrum is the
principal anatomic site of diseases... Pictures
... READ EXCERPTS »
... Author: Megha Shah Fitzpatrick, MD
What to Do - Interpret the Data
Herniation occurs when the brain shifts across structures within the skull,
from one intracranial compartment to another, as a result of pressure... Central Herniation Syndrome ... Uncal Herniation Syndrome ... Cerebellar Tonsillar Herniation Syndrome ... Suggested Readings
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The father of television personality Linda Dano experienced years of mental deterioration before he was diagnosed with Alzheimer's disease. Hear...
Alzheimer's disease is a common, but often misunderstood condition. Forgetfulness is just one small symptom of a larger, more complicated disease...
While the causes of Alzheimer's are still uncertain, many experts believe the key lies in understanding plaques and tangles, lesions and knots of...