scholarly journals The Optimal Management of Acute Febrile Encephalopathy in the Aged Patient: A Systematic Review

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Fereshte Sheybani ◽  
HamidReza Naderi ◽  
Sareh Sajjadi
Keyword(s):  
Systematic Review ◽  
Mental Status ◽  
The Elderly ◽  
Altered Mental Status ◽  
Cns Infection ◽  
Geriatric Syndrome ◽  
World Population ◽  
Main Process ◽  
Optimal Management ◽  
Language Restriction

The elderly comprise less than 13 percent of world population. Nonetheless, they represent nearly half of all hospitalized adults. Acute change in mental status from baseline is commonly seen among the elderly even when the main process does not involve the central nervous system. The term “geriatric syndrome” is used to capture those clinical conditions in older people that do not fit into discrete disease categories, including delirium, falls, frailty, dizziness, syncope, and urinary incontinence. Despite the growing number of elderly population, especially those who require hospitalization and the high burden of common infections accompanied by encephalopathy among them, there are several unresolved questions regarding the optimal management they deserve. The questions posed in this systematic review concern the need to rule out CNS infection in all elderly patients presented with fever and altered mental status in the routine management of febrile encephalopathy. In doing so, we sought to identify all potentially relevant articles using searches of web-based databases with no language restriction. Finally, we reviewed 93 research articles that were relevant to each part of our study. No prospective study was found to address how should AFE in the aged be optimally managed.

Altered Mental Status in the Elderly

1984 ◽  
Vol 11 (4) ◽  
pp. 653-665
Author(s):  
Bruce L. Miller ◽  
Stephen L. Read ◽  
Michael E. Mahler ◽  
D. Frank Benson
Keyword(s):  
Mental Status ◽  
The Elderly ◽  
Altered Mental Status

Altered mental status in the elderly

2016 ◽  
pp. 58-70
Author(s):  
Josh Joseph ◽  
Maura Kennedy
Keyword(s):  
Mental Status ◽  
The Elderly ◽  
Altered Mental Status

scholarly journals When a Seemingly Harmless Prescription Turns into Toxicity

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Zurab Azmaiparashvili ◽  
Kevin Bryan Lo ◽  
Nawal Habib ◽  
Annie Hsieh
Keyword(s):  
Renal Function ◽  
Differential Diagnosis ◽  
Herpes Zoster ◽  
Cognitive Function ◽  
Mental Status ◽  
Complete Resolution ◽  
Impaired Renal Function ◽  
Supportive Therapy ◽  
The Elderly ◽  
Altered Mental Status

Valacyclovir neurotoxicity is commonly seen in the elderly and those with impaired renal function. Differential diagnosis can be challenging as a myriad of medical conditions, including herpes zoster virus associated encephalitis, may present in a similar fashion. We present a case of a 71-year-old male who presented with altered mental status in the setting of recent herpes zoster eruption. His condition was attributed to valacyclovir neurotoxicity, and initiation of appropriate supportive therapy was met with complete resolution of symptoms and normalization of cognitive function.

scholarly journals Unusual presentation of meningococcal meningitis in the elderly and utility of CSF PCR testing

2020 ◽  
Vol 2 (10) ◽  
Author(s):  
Elizabeth Ranson ◽  
Hannah Ship ◽  
Omai Garner ◽  
Shangxin Yang ◽  
Debika Bhattacharya
Keyword(s):  
Mental Status ◽  
Unusual Case ◽  
The Elderly ◽  
Altered Mental Status ◽  
Meningococcal Meningitis ◽  
Unusual Presentation ◽  
Nuchal Rigidity

We present an unusual case of a previously healthy 74-year-old man who presented with diffuse weakness, severe myalgias, petechial palmar rash and hypotension, but without fever, altered mental status, nuchal rigidity or headache, who was ultimately found through PCR testing to have meningococcal meningitis.

Altered mental status in the elderly

2014 ◽  
pp. 102-113
Author(s):  
Scott T. Wilber ◽  
Jin H. Han ◽  
Joseph H. Kahn ◽  
Jonathan S. Olshaker
Keyword(s):  
Mental Status ◽  
The Elderly ◽  
Altered Mental Status

scholarly journals Poisoning due to ingestion of amatoxin-containing mushrooms in South Korea: a systematic review and meta-analysis

2021 ◽  
Keyword(s):  
Systematic Review ◽  
Central Nervous System ◽  
Nervous System ◽  
South Korea ◽  
Mental Status ◽  
Meta Analysis ◽  
Case Series ◽  
Altered Mental Status ◽  
Watery Diarrhea ◽  
Mushroom Poisoning

Objective: Poisoning caused by the ingestion of amatoxin-containing mushrooms is life-threatening and requires urgent attention. However, only few studies have evaluated the factors that predict mortality owing to mushroom poisoning. We conducted a systematic review of amatoxin poisoning in South Korea and meta-analysis of the association between severe early-stage central nervous system symptoms and mortality in cases of amatoxin poisoning. Methods: The Embase, MEDLINE, Web of Science, KMbase, and Korean Studies Information System databases were searched for articles up to July 2020. We included case reports, case series, and observational studies on Amanita poisoning in South Korea. Outbreak area, incubation time, clinical course, management, and outcomes were evaluated. We then conducted a meta-analysis of the association between severe central nervous system symptoms and mortality. Results: Sixteen articles were included in the review and five in the meta-analysis. Outbreaks occurred principally in Gyeongbuk and in the western part of Gangwon. All patients had gastrointestinal symptoms, such as watery diarrhea. Liver failure occurred 2-3 days after mushroom intake in most patients, and ingestion of amatoxins from mushroom consumption was associated with high mortality risk. The risk of mortality among patients with altered mental status or seizures was 10 times higher than that among patients without these symptoms (risk ratio = 10.56, 95% confidence interval = 2.73-40.83). Conclusions: Amanita mushrooms are often mistaken for edible mushrooms, and their ingestion is frequently fatal. Aggressive treatment must be pursued in patients with severe central nervous system symptoms, such as altered mental status or seizures.

Successful treatment of dermato-neuro syndrome with plasmapheresis

2020 ◽  
Vol 13 (12) ◽  
pp. e237170
Author(s):  
Jose Maciel Larios ◽  
Jordan Ciuro ◽  
Thomson Sam Varghese ◽  
Susan Elizabeth Lyons
Keyword(s):  
Mental Status ◽  
Rare Case ◽  
Altered Mental Status ◽  
Optimal Management ◽  
Treatment Protocols ◽  
Common Causes ◽  
History Of ◽  
Clonic Seizures ◽  
Neurologic Function ◽  
Rule Out

Altered mental status can have many causes ranging from emergent intracranial pathologies to more insidious, systemic toxic aetiologies. We report a rare case of dermato-neuro syndrome in a 71-year-old man with a known history of scleromyxoedema. The patient initially presented with encephalopathy which quickly progressed to generalised tonic–clonic seizures and coma. While his presentation fits with other, although rare, cases of dermato-neuro syndrome, it is imperative to rule out lethal, more common causes of altered mentation. Due to the rarity and difficulty in diagnosis of dermato-neuro syndrome, there is a significant debate regarding the optimal management as there are no standardised treatment protocols. In our case, the patient was successfully treated with plasmapheresis resulting in improved neurologic function.

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