Differential Diagnosis for Altered Mental Status in Children
Single Most Likely Diagnosis
- Infection (e.g., meningitis, sepsis): This is often the most common cause of altered mental status in children, as they are more susceptible to infections due to their developing immune systems.
Other Likely Diagnoses
- Trauma (e.g., head injury): Head injuries are common in children and can lead to altered mental status due to concussion, intracranial hemorrhage, or other complications.
- Metabolic disorders (e.g., diabetic ketoacidosis, hypoglycemia): Children with underlying metabolic conditions are at risk for altered mental status due to fluctuations in blood glucose levels or other metabolic imbalances.
- Toxins or ingestions (e.g., medication overdose, substance abuse): Accidental or intentional ingestions of toxic substances can cause altered mental status in children.
- Seizures or status epilepticus: Seizures can cause altered mental status, and status epilepticus is a medical emergency that requires prompt treatment.
Do Not Miss Diagnoses
- Reye's syndrome: A rare but potentially fatal condition that can cause altered mental status, seizures, and liver dysfunction, often associated with aspirin use during viral infections.
- Brain tumor or hydrocephalus: Although rare, these conditions can cause altered mental status, and prompt diagnosis is crucial for effective treatment.
- Inborn errors of metabolism (e.g., maple syrup urine disease): These conditions can cause altered mental status, and early diagnosis is essential for preventing long-term damage.
- Meningitis or encephalitis due to uncommon pathogens (e.g., Lyme disease, Rocky Mountain spotted fever): These infections can cause altered mental status, and prompt diagnosis is necessary to initiate appropriate treatment.
Rare Diagnoses
- Mitochondrial disorders (e.g., Kearns-Sayre syndrome): These conditions can cause altered mental status, but are relatively rare and often require specialized testing for diagnosis.
- Autoimmune encephalitis: A rare condition that can cause altered mental status, seizures, and other neurological symptoms, often requiring immunotherapy for treatment.
- Neurodegenerative disorders (e.g., juvenile Huntington's disease): These conditions can cause altered mental status, but are relatively rare and often have a gradual onset.
- Intracranial vascular malformations or moyamoya disease: These conditions can cause altered mental status, but are relatively rare and often require specialized imaging for diagnosis.