Differential Diagnosis for Anorexia with Acute Neurological Change
- Single most likely diagnosis:
- Wernicke's Encephalopathy: This condition is caused by thiamine deficiency, often seen in individuals with malnutrition, including those with anorexia nervosa. Acute neurological changes such as confusion, ataxia, and ophthalmoplegia are hallmark symptoms.
- Other Likely diagnoses:
- Electrolyte Imbalance: Severe electrolyte disturbances (e.g., hyponatremia, hypokalemia) can lead to acute neurological changes in individuals with anorexia due to malnutrition and purging behaviors.
- Hypoglycemia: Low blood sugar can cause confusion, seizures, and even coma, especially in individuals with anorexia who may have poor nutritional intake.
- Dehydration: Severe dehydration can lead to acute neurological symptoms, including confusion and altered mental status.
- Do Not Miss diagnoses:
- Cerebral Vasculitis: Although rare, cerebral vasculitis can present with acute neurological changes and is potentially life-threatening if not promptly treated.
- Subarachnoid Hemorrhage: A sudden, severe headache with acute neurological changes could indicate a subarachnoid hemorrhage, which requires immediate medical attention.
- Meningitis/Encephalitis: Infections of the brain and meninges can present with acute neurological changes and are medical emergencies.
- Rare diagnoses:
- Refeeding Syndrome: Although more of a metabolic concern, refeeding syndrome can lead to acute neurological changes due to shifts in electrolytes and fluids during the refeeding process.
- Pituitary Apoplexy: A rare condition involving hemorrhage or infarction of the pituitary gland, which can present with acute neurological symptoms, including headache and visual disturbances.
- CNS Lymphoma: A rare type of cancer that can present with acute neurological changes, especially in immunocompromised individuals.