Depressed consciousness

Question 1

What is the most common aetiology of depressed conscious state in the ED

Answer 1

toxins are the most common but most cases are due to toxic, metabolic or infectious causes.

Question 2

Discuss broad DDX of depressed concious state

Answer 2

Metabolic

• DKA, hypoglycaemia
• Beriberi
• Adrenal crisis
• Pituitary apoplexy
• Sepsis
• Wernickes
• Hyponatraemia
• hyperammonemia
• hypercalcemia
• hepatic encephalopahy
• thyrotoxic crisis
• myxoedema coma
• heat stroke

Toxic

• Opiates
• hypoglycaemic agents
• carbon monoxide
• histotoxic hypoxia
• methemoflobinemia
• sedatives
• toxic alcohols (methanyl ethanol glycal)

Structual

• haemorrohage
• cortical infarct
• cerebellar infarct