scholarly journals Neurology in the psychiatric patient: how to think about differentials in altered mental status and diagnoses not to miss – CORRIGENDUM

2022 ◽  
pp. 1-1
Author(s):  
Jonathan McLaughlin ◽  
Tim Young
Keyword(s):  
Mental Status ◽  
Psychiatric Patient ◽  
Altered Mental Status

Neurology in the psychiatric patient: how to think about differentials in altered mental status and diagnoses not to miss

2021 ◽  
pp. 1-13
Author(s):  
Jonathan McLaughlin ◽  
Tim Young
Keyword(s):  
Differential Diagnosis ◽  
Mental Status ◽  
Psychiatric Patient ◽  
Common Ground ◽  
Altered Mental Status ◽  
Management Plan ◽  
Case Vignettes ◽  
Neurological Conditions ◽  
Set Up ◽  
Careful History

SUMMARY A wide variety of neurological conditions may present first to a psychiatrist and it is important to be aware of these in differential diagnosis. A careful history, examination and a broad differential diagnosis can help set up an appropriate management plan – with room to change if things change in unexpected ways. In this article we explore common ground shared by psychiatry and neurology and show how incorporation of neurological knowledge can improve the practice of psychiatry. Using four fictional case vignettes of altered mental status we explore important neurological differential diagnoses which could present to the Psychiatrist.

Abstract #542 An Unusual Initial Presentation of Active Pulmonary Tuberculosis: Severe Hypercalcemia with Altered Mental Status and Renal Failure

2018 ◽  
Vol 24 ◽  
pp. 130
Author(s):  
Matthew Mandell ◽  
Jennifer Velasco ◽  
Armand Krikorian ◽  
Anupama Ananth ◽  
Joumana Chaiban ◽  
...  
Keyword(s):  
Renal Failure ◽  
Pulmonary Tuberculosis ◽  
Mental Status ◽  
Altered Mental Status ◽  
Initial Presentation ◽  
Active Pulmonary Tuberculosis ◽  
Severe Hypercalcemia

Transient altered mental status and leptomeningeal enhancement associated with pembrolizumab: a case report

2021 ◽  
Author(s):  
Keng Lam ◽  
Sameer K. Kulkarni ◽  
Manya Khrlobyan ◽  
Pamela K. Cheng ◽  
Caroline L. Fong
Keyword(s):  
Case Report ◽  
Mental Status ◽  
Altered Mental Status ◽  
Leptomeningeal Enhancement

scholarly journals Recurrent noncirrhotic hyperammonemia causing acute metabolic encephalopathy in a patient with a continent ileocecal pouch: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
T. M. Skipina ◽  
S. Macbeth ◽  
E. L. Cummer ◽  
O. L. Wells ◽  
S. Kalathoor
Keyword(s):  
Emergency Department ◽  
Metabolic Acidosis ◽  
Mental Status ◽  
Rare Case ◽  
Liver Function Tests ◽  
Altered Mental Status ◽  
Potassium Citrate ◽  
Metabolic Encephalopathy ◽  
History Of ◽  
Normal Urine

Abstract Introduction Acute encephalopathy, while a common presentation in the emergency department, is typically caused by a variety of metabolic, vascular, infectious, structural, or psychiatric etiologies. Among metabolic causes, hyperammonemia is relatively common and typically occurs in the setting of cirrhosis or liver dysfunction. However, noncirrhotic hyperammonemia is a rare occurrence and poses unique challenges for clinicians. Case presentation Here we report a rare case of a 50-year-old Caucasian female with history of bladder cancer status post chemotherapy, radical cystectomy, and ileocecal diversion who presented to the emergency department with severe altered mental status, combativeness, and a 3-day history of decreased urine output. Her laboratory tests were notable for hyperammonemia up to 289 μmol/L, hypokalemia, and hyperchloremic nonanion gap metabolic acidosis; her liver function tests were normal. Urine cultures were positive for Enterococcus faecium. Computed tomography imaging showed an intact ileoceal urinary diversion with chronic ileolithiasis. Upon administration of appropriate antibiotics, lactulose, and potassium citrate, she experienced rapid resolution of her encephalopathy and a significant reduction in hyperammonemia. Her hyperchloremic metabolic acidosis persisted, but her hypokalemia had resolved. Conclusion This case is an example of one of the unique consequences of urinary diversions. Urothelial tissue is typically impermeable to urinary solutes. However, when bowel segments are used, abnormal absorption of solutes occurs, including exchange of urinary chloride for serum bicarbonate, leading to a persistent hyperchloremic nonanion gap metabolic acidosis. In addition, overproduction of ammonia from urea-producing organisms can lead to abnormal absorption into the blood and subsequent oversaturation of hepatic metabolic capacity with consequent hyperammonemic encephalopathy. Although this is a rare case, prompt identification and treatment of these metabolic abnormalities is critical to prevent severe central nervous system complications such as altered mental status, coma, and even death in patients with urinary diversions.

scholarly journals Altered mental status is an independent predictor of mortality in hospitalized COVID-19 patients

2021 ◽  
Author(s):  
Marjorie J. Kenerly ◽  
Priyank Shah ◽  
Hiten Patel ◽  
Rilee Racine ◽  
Yash Jani ◽  
...  
Keyword(s):  
Mental Status ◽  
Independent Predictor ◽  
Altered Mental Status

scholarly journals Altered mental status with mirror giant middle cerebral artery aneurysms: A case report

2021 ◽  
pp. 101154
Author(s):  
Kamil W. Nowicki ◽  
Jasmine L. Hect ◽  
Nallamai Muthiah ◽  
Arka N. Mallela ◽  
Benjamin M. Zussman
Keyword(s):  
Case Report ◽  
Middle Cerebral Artery ◽  
Mental Status ◽  
Cerebral Artery ◽  
Altered Mental Status ◽  
Middle Cerebral Artery Aneurysms

scholarly journals PROLONGED HYPERCALCEMIA FROM ANTIBIOTIC-ELUTING CALCIUM SULFATE BEADS

2019 ◽  
Vol 5 (6) ◽  
pp. e349-e351 ◽  
Author(s):  
Amy Vora ◽  
Sadia Ali
Keyword(s):  
Renal Failure ◽  
Mental Status ◽  
Serum Calcium ◽  
Calcium Sulfate ◽  
Volume Overload ◽  
Altered Mental Status ◽  
Caucasian Woman ◽  
Local Antibiotics ◽  
Joint Infections ◽  
Severe Hypercalcemia

Objective: Calcium sulfate beads (CSBs) are biocompatible hydrophilic crystals that are used to deliver local antibiotics in periprosthetic joint infections. Hypercalcemia after placement of CSBs is uncommon and poorly understood. Methods: We present the case of a woman who presented with symptomatic hypercalcemia after placement of antibiotic-eluting CSBs. Results: A 58-year-old, Caucasian woman presented with altered mental status, respiratory failure, and septic shock 2 days after placement of antibiotic-eluting CSBs for a left prosthetic hip infection. Laboratory analysis revealed severe hypercalcemia at presentation. She had no known history of fractures, kidney stones, parathyroid, or calcium disorders. She was not on any medications that could induce hypercalcemia. She was treated with aggressive intravenous hydration and 8 doses of calcitonin. Due to impaired renal function, bisphosphonate was contraindicated. She subsequently became anuric with worsening renal failure and volume overload and the decision was made to initiate dialysis. She received 8 days of continuous renal replacement therapy followed by 2 sessions of hemodialysis which improved her serum calcium levels, mental status, and renal failure with no long-term complications. Conclusion: Hypercalcemia secondary to the placement of antibiotic-eluting CSBs is rare. Larger volumes of CSBs may contribute to hypercalcemia. In some cases, hypercalcemia can be severe and symptomatic as in the case of our patient. Serum calcium levels should be monitored frequently after placement of CSBs and managed as appropriate.

A man in his 40s with altered mental status, ataxia and unilateral weakness

2016 ◽  
Vol 37 (3) ◽  
pp. 286-290
Author(s):  
Konark Malhotra ◽  
Monica Khunger ◽  
Cunfeng Pu ◽  
Thomas F. Scott
Keyword(s):  
Mental Status ◽  
Altered Mental Status ◽  
Unilateral Weakness

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.

Sign in / Sign up

Export Citation Format

Share Document