altered sensorium
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2021 ◽  
Vol 10 (6) ◽  
pp. 3837-3839
Author(s):  
G.N Sharma

Altered sensorium or altered level of consciousness is a common complaint among electrolyte abnormality patients and has several synonyms like altered behaviour, generalized weakness, lethargy, agitation, psychosis, disorientation, inappropriate behaviour, inattention, confusion, hallucination. The aim of the study was to evaluate the prevalence and to assess the level of consciousness dysnatremic patients at a tertiary care hospital. A prospective observational study, serum sodium level and other clinical profiles were recorded in a data collection form. GCS was used to analyses the level of consciousness among the enrolled patients. SPSS 22.0 statistical software was used for data analysis. During the study period, a total of 482 patients were enrolled in the study. Based on the serum sodium, they were categorized into Hyponatraemic (410) and Hyponatraemic (72) patients. Our study found a greater number of patients in the age group above 60 years and found that sodium imbalance increases generally in males with increasing age. Our study found that altered sensorium (60%) was predominant more in hyponatremia patients. Chi square test was performed to find statistically significant difference in level of consciousness between hypo and Hyponatraemic patients and was found to be significant p value (≤ 0.05). Abnormalities of plasma sodium are probably the most common electrolyte disorders and they are associated with serious morbidity including a poorer long-term neurologic outcome.


2021 ◽  
pp. 004947552110531
Author(s):  
Laxmikant Ramkumarsingh Tomar ◽  
Neha Pandita ◽  
Sakshi Arya ◽  
CS Agrawal

Neurological side-effects of linezolid manifesting as a posterior reversible leuco-encephalopathy syndrome (PRES) is rare. Early identification of this offending drug might reverse this catastrophic event. We report a 45-year-old female, who was diagnosed as a case of disseminated tuberculosis and was treated with antitubercular drugs (ATT), but later developed ATT-induced hepatitis. She was then put on modified ATT (moxifloxacin, terizidone, and linezolid). In the next two days she developed an altered sensorium. Brain imaging was suggestive of PRES. Linezolid was withdrawn, following which she showed an excellent clinical and radiological recovery.


2021 ◽  
pp. 7-10
Author(s):  
Nupoor Vaghasia ◽  
Bharatsing D. Rathod ◽  
Vidya Nagar

BACKGROUND: Tuberculous meningitis (TBM) is one of the most fatal forms of tuberculosis, early diagnosis and treatment of which can reduce morbidity and mortality. This study was undertaken to achieve data regarding clinical prole and outcome of patients from western India as epidemiological data is lacking from this region. METHODS: This prospective observational study was conducted on 136 patients admitted in medical ward and critical care unit of a tertiary care hospital in Maharashtra over 18 months. Clinical, biochemical, radiological and microbiological evaluation was done. Data was analyzed using SPSS 22 version software and p value of <0.05 as signicant. RESULTS: The mean age of cases was 35.2 ± 14.69 years, majority from age group of 18 - 40 years. Out of 136 cases, 62 (45.6%) were males and 74 (54.4%) females. Commonest clinical features were fever and headache, followed by altered sensorium and seizure. Symptoms were mostly of acute onset (<14 days). 42 cases (30.9%) were associated with present or past pulmonary tuberculosis and 34 (25%) with retroviral disease. 7 cases (5.2%) had hemiparesis and 3 (2.2%) had ophthalmoplegia. Mean ESR was 56.59 + 22.87. CSF showed lymphocytosis (mean 88.4 + 18.09 %), low glucose percentage (mean 39.57 + 0.2 %) and high protein (mean 146.02 + 106.62 mg/dl). 117 cases (86%) showed positive neuroimaging. Outcome was poor in stage III disease. CONCLUSION: Tuberculous meningitis usually presents as acute onset illness with fever, headache or altered sensorium. CSF Gene Xpert has low sensitivity as compared to neuroimaging. Advanced disease was associated with poor outcome.


2021 ◽  
pp. 32-33
Author(s):  
Syed Idrees Hassan Sajjad ◽  
Dandu Venkata Satya Sanjay Varma

Olanzapine is a readily available atypical antipsychotic usually prescribed in adults for psychotic disorders. Olanzapine overdose or poisoning is rarely seen in children. It is often due to accidental intake of drug and sometimes suicidal.We are reporting two case of olanzapine poisoning in children presenting with altered sensorium and pinpoint pupils. The mainstay of treatment of olanzapine poisoning is supportive and symptomatic measures. Both children recovered well and were discharged.


2021 ◽  
Vol 429 ◽  
pp. 118232
Author(s):  
Uma Ravishankar ◽  
P. Sathyamurthy ◽  
Philo Hazeena ◽  
Shankar Venkatasubramanian ◽  
Sundar Shanmugam ◽  
...  

2021 ◽  
Vol 8 (33) ◽  
pp. 3134-3138

BACKGROUND Metabolic encephalopathy (ME) is one of the most frequently encountered and broadly defined diagnoses by the physicians in the intensive care setting. ME is a clinical state characterized by cerebral dysfunction in the absence of structural brain disease. The causes are many and often multifactorial. The purpose of study was to evaluate various causes, clinical profile, and outcome in patients with ME. METHODS This is a hospital based, observational, cross sectional study, conducted in ICU of Department of General medicine, S.N. Medical College, Bagalkot. Patients with head trauma, organic causes of altered sensorium, psychiatric conditions were excluded. RESULTS Mean age was 51.22 ± 17.24 years. Majority were males. Diabetes was the most common comorbidity found followed by cirrhosis of liver and hypertension. Septic causes were found to be the most common aetiology. 80.7 % recovered from the disease and death was noted in 19.3 % patients. CONCLUSIONS All the patients with ME had altered level of consciousness with fever being the most common symptom. Most of them were males, most common aetiology was septic cause, and recovery was seen in about 80.7 % of patients. KEYWORDS Metabolic Encephalopathy, Altered Sensorium, Sepsis


2021 ◽  
Vol 15 (1) ◽  
pp. 31-36
Author(s):  
Jayanti K Gurumukhani ◽  
Harsh D. Patel ◽  
Dhruvkumar M. Patel ◽  
Mukundkumar V. Patel ◽  
Maitri M. Patel ◽  
...  

Background: Posterior reversible encephalopathy syndrome (PRES) is clinicoradiological disease entity characterized by headache, seizures, altered sensorium and corticalvisual loss with characteristic MRI features of subcortical white matter hyperintensities on T2W imaging. Though hypertension is a traditional hallmark of PRES, uncommon causes without hypertension have been described. We report an unusual such case without hypertension, precipitated by red cell transfusion. Case Presentation: A 40 years female received six units of packed cell transfusion for severe anemia (Hemoglobin 3.0 Gm %) transfused over 8 hours. She was having menorrhagia and was operated on for a hysterectomy. She developed a headache on the second postoperative day for five days and no cause was revealed in spite of extensive workup, including MRI brain and CSF study. On the sixth day, she had recurrent seizures followed by altered sensorium in the absence of hypertension. Her repeat MRI brain findings were consistent with PRES. Conclusion: We reviewed 25 cases, including the present one as PRES after the blood transfusion. 24 were females, and 16 of 19 developed PRES in the course of chronic anemia lasting over 1 month. Anemia was severe in 18 of 25 cases, with haemoglobin (Hb) levels < 4.0 Gm%. In 16 of 20 cases, Hb levels increased to 5 g/dl by red cell blood transfusion until the onset of PRES. On MRI brain, 23 of 25 cases showed vasogenic edema and 3 of 25 cases showed an irreversible neurological deficit. When treating severe chronic anemia rapid correction of Hb with blood transfusion, one should consider a possibility of PRES in post-transfusion neurological symptoms in spite of normal diagnostic workup.


2021 ◽  
pp. 71-73
Author(s):  
Sharma S ◽  
Chakrabarti D ◽  
Saha S ◽  
Banik S ◽  
Mondal S

Introduction: The clinical features of Acute Encephalitis syndrome (AES) vary widely across the world and little documentation is available from North Bengal. Materials and methods: A cross –sectional observational study was conducted at the Department of Medicine of a teaching hospital in North Bengal. 104 AES cases were enrolled and clinically evaluated and investigated as per the study protocol. Results:JE (72%) was most common causative agent followed by HSV Encephalitis (11.5%), Scrub Typhus (9.6%) and Dengue Encephalitis (2.88%). Male cases were predominant than female in our study. Fever and altered sensorium were most common presentation followed by seizures (51.9%), headache (29.8%), vomiting (18.2%), and hemiplegia (4.8%). Neurological evaluation revealed 80% of the patients had neck stiffness followed by positive Babinski sign (45.19%) and hypertonia (35%). Conclusions: JE is the commonest cause of AES in North Bengal and seizures are the commonest neurological manifestation after altered sensorium.


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