Altered Mental Status or Confusion

Head | Neurology | Altered Mental Status or Confusion (Symptom)


Alteration mental status is a condition characterized by general changes in brain function, such as confusion, amnesia the state of memory loss, loss of alertness or orientation. Other features are judgment or thought deficiency, decrease regulation of emotions and disruptions in perception, psychomotor skills and behavior.


An altered level of consciousness can occur from the following factors: alterations in the chemical environment of the brain like exposure to poisons or intoxicants, insufficient oxygen or blood flow in the brain, and excessive pressure within the skull.

While an altered mental status is obviously characteristic of a number of psychiatric and emotional conditions, medical conditions and injuries that cause damage to the brain can also cause mental status changes. Confusion, lethargy, delirium, dementia, encephalopathy, and organic brain syndrome are all terms that have been used to refer to conditions hallmarked by mental status changes.

An altered level of consciousness is any measure of arousal other than normal. Level of consciousness (LOC) is a measurement of a person's arousability and responsiveness to stimuli from the environment.

A deficit in the level of consciousness suggests that both of the cerebral hemispheres or the reticular activating system have been injured. A decreased level of consciousness correlates to increased morbidity (disability) and mortality (death).

Diagnosis and Treatment

Physical examination should be thorough. Possible helpful findings include signs of head trauma, icterus, hydration status, dry mouth, a bitten tongue, nuchal rigidity, heart murmurs, and abdominal tenderness. Given the vast differential of AMS, investigations should be guided by history and physical examination findings.