Confused

Introduction Symptoms of consciousness, manifested as confusion and confusion, answering questions or answering confusion. Ambiguity is a mild disturbance of consciousness. It is manifested in indifference to oneself and the surrounding environment. The answer is short and sluggish, the expression is indifferent, and the orientation of time, place, and character is completely or partially impeded. Pay attention to changes in consciousness and patient safety, keep the rest of the environment quiet, and supply enough nutrients and water.

Cause

1. Systemic diseases: dehydration, adrenal insufficiency;

2. Simple autonomic nervous function insufficiency;

3. Central nervous system diseases: Shy-Drager syndrome, brain stem disease Parkinson disease, myelopathy, multiple cerebral infarction;

4. Peripheral and autonomic neuropathy: diabetes, amyloidosis, bone marrow spasm, tumor-like syndrome, alcohol and nutritional diseases; increased adrenal and sympathetic activity leading to vasoconstriction and selective skin and internal organs (including liver and kidney) Blood flow drops. The above metabolic and hemodynamic factors lead to an increase in lactic acid production.

5. Drugs: phenothiazine and other antipsychotics, monoamine oxidase inhibitors, tricyclic antidepressants, antihypertensives, levodopa, vasodilators, beta-blockers, calcium channel blockers.

an examination

Related inspection

EEG examination of brain CT

12-lead ECG can indicate arrhythmia, conduction abnormalities, ventricular hypertrophy, pre-excitation syndrome, QT prolongation, pacemaker failure, or myocardial ischemia and myocardial infarction. If there is no clinical evidence, at least 24-hour ambulatory electrocardiography should be performed. Any arrhythmia that can be captured may be the cause of the change in consciousness, but most patients do not experience repeated syncope during the monitoring. Recorder playback is valuable if there are aura symptoms before syncope. A small number of syncope patients with elevated serum troponin or phosphocreatine kinase should be considered for acute myocardial infarction. If the aerobic partial pressure is reduced and the ECG has evidence of acute pulmonary heart disease with pulmonary embolism, monitoring of lung perfusion and ventilation scans is an excellent screening technique. If you suspect a seizure, you should do an EEG. When the diagnosis is not clear, such as suspected intracranial lesions or focal neuropathy, head and brain CT and magnetic resonance are performed as differential diagnosis.

Differential diagnosis

The diagnosis should be differentiated from the following symptoms:

1. Unconsciousness: It means that the mind is faint, when the time is clear, the call is ok, or there is a slang.

2. The mind is sorrowful: the call can be answered, but the answer is not asked, the memory and calculation power are poor. The spirit is not concentrated or the mind is unclear.

3. Apathy: A symptom of the mind, manifested as a slow response to the outside world, calling no response, but not a coma.

Asking the patient, I found that the response was slow, the consciousness was unclear, and the answer was confusing to diagnose.

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