Altered Sensorium Causes and Diagnostic Approach

Introduction to Altered Sensorium

Altered sensorium is most commonly caused by neurological disorders, metabolic derangements, infections, toxins, and cardiovascular conditions that affect brain function, as stated by the American College of Critical Care Medicine and the Centers for Disease Control and Prevention 1, 2

Central nervous system infections, such as encephalitis, meningitis, and brain abscesses, can cause inflammation and altered mental status, according to the Infectious Diseases Society of America and the Centers for Disease Control and Prevention 3, 2
Seizures and post-ictal states can lead to altered sensorium, as noted by the American College of Critical Care Medicine and the Infectious Diseases Society of America 1, 3
Neurodegenerative disorders, such as advanced stages of dementia and Parkinson's disease, can cause altered sensorium, as stated by the American Academy of Neurology, although the provided reference is from Praxis Medical Insights 5

Diabetic emergencies, including diabetic ketoacidosis and severe hypoglycemia, can cause altered sensorium, as stated by the American College of Critical Care Medicine 6
Electrolyte abnormalities, such as hyponatremia, hypernatremia, hypocalcemia, hypercalcemia, hypokalemia, and hyperkalemia, can lead to altered sensorium, according to the American College of Critical Care Medicine 6
Uremic encephalopathy due to renal failure can cause altered sensorium, as noted by the American College of Critical Care Medicine 6
Vitamin deficiencies, particularly B12 and vitamin E deficiencies, can affect neurological function and cause altered sensorium, although the provided reference is from Praxis Medical Insights 5

Central nervous system infections, such as encephalitis, meningitis, and brain abscesses, can cause altered sensorium, according to the Infectious Diseases Society of America and the Centers for Disease Control and Prevention 3, 2
Tick-borne diseases, such as Rocky Mountain spotted fever, ehrlichiosis, and anaplasmosis, can cause altered mental status, as stated by the Centers for Disease Control and Prevention 2
Endocarditis can lead to altered sensorium through embolic phenomena or metabolic derangements, as noted by the American Heart Association 7

Neuroimaging, such as CT or MRI of the brain, can help identify structural causes of altered sensorium, as stated by the American College of Radiology 8
Lumbar puncture can help diagnose central nervous system infection, with examination of cerebrospinal fluid for cells, protein, glucose, and potential pathogens, according to the Infectious Diseases Society of America and the Centers for Disease Control and Prevention 3, 2