Differential Diagnosis for Altered Mental Status (AMS)
- Single most likely diagnosis:
- Hypoglycemia: A common and easily reversible cause of AMS, particularly in diabetic patients or those with a history of skipping meals.
- Other Likely diagnoses:
- Intoxication or substance withdrawal: Alcohol, drugs, or medication overdose can lead to AMS.
- Infection (e.g., meningitis, encephalitis, sepsis): Infections can cause AMS, especially in elderly or immunocompromised patients.
- Traumatic brain injury: Head trauma can result in AMS due to concussion, subdural hematoma, or other intracranial injuries.
- Metabolic disorders (e.g., hepatic encephalopathy, uremia): Electrolyte imbalances, liver or kidney failure can cause AMS.
- Do Not Miss diagnoses:
- Stroke or transient ischemic attack (TIA): Although less common, these conditions are medical emergencies requiring prompt intervention.
- Status epilepticus: Prolonged seizure activity can present with AMS and is a life-threatening condition.
- Meningitis or encephalitis: Infections of the central nervous system can be fatal if not treated promptly.
- Hyperthermia or hypothermia: Extreme temperatures can cause AMS and are life-threatening if not addressed.
- Rare diagnoses:
- Wernicke's encephalopathy: A condition caused by thiamine deficiency, often seen in chronic alcoholics.
- Hashimoto's encephalopathy: A rare condition associated with autoimmune thyroiditis.
- Creutzfeldt-Jakob disease: A rare, degenerative, and fatal brain disorder.
- Reye's syndrome: A rare but serious condition that causes swelling in the liver and brain, often associated with viral infections and aspirin use in children.