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IMPAIRED CONSCIOUSNESS / ACUTE CONFUSIONAL STATE |
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infections: |
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encephalitis (eg. herpes simplex)typhoid fever septicaemia severe pneumonia |
meningitis (viral, bacterial, fungal, tuberculous, cryptococcal)cerebral abscess cerebral malaria (usually falciparum)HIV encephalopathy |
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vascular lesions: |
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cerebral thrombosis / embolism (including fat embolism)intracerebral bleed subarachnoid bleed subdural or extradural haematoma hypertensive encephalopathy hypotension (shock from any cause)transient global amnesia (no loss of consciousness) |
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space-occupying lesions: |
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tumours (primary or metastatic)cerebral abscess |
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metabolic: |
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renal or hepatic failure electrolyte, osmotic and acid-base disturbances , eg. hyponatraemia, hypercalcaemiaacute porphyrias |
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endocrine: |
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diabetic ketoacidosis thyrotoxic crisis Addisonian crisis |
hypoglycaemia hypothyroidism ('myxoedema madness')Cushing's syndrome |
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toxins / drugs: |
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alcohol intoxication or withdrawal opiates (heroin, etc.), cannabis, amphetaminesbarbiturates, benzodiazepines, tricyclic antidepressants salicylates digoxin |
steroids indomethacin cimetidine carbon monoxide poisoning lead (especially organic form)atropine |
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anoxia: |
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severe cardiac or respiratory failure from any cause, including arrhythmias severe anaemia |
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nutritional deficiencies: |
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B 1 (Wernicke's encephalopathy) and/or B12 ,especially in alcoholicsnicotinic acid (niacin) in pellagra (triad of dementia, diarrhoea and dermatitis) |
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other / miscellaneous causes: |
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psychiatric disease/hysterical state narcolepsy head injury (cerebral contusion)hyperthermia, eg. heat strokeeclampsia post-ictal hypothermia (besides hypothyroidism) |
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