Thirty Nine Flashcards
What are some clinical features of nervous system metabolic disorders?
Symptoms and signs vary widely in degree depending on the severity of the
pathological disturbance. They also vary in type, but they are characterized by their
bilateral or diffuse involvement of the nervous system due to a generalized disturbance of
metabolism. The clinical picture is known as a metabolic encephalopathy. Interference in
the elaborate functions of the cerebral hemispheres is clinically manifested by an altered
mental status. Bilateral impairment of the reticular activating system or the cerebral
hemispheres alters consciousness that ranges from obtundation to coma. Altered cortical
activity limits concentration, slows thinking and degrades cognition. Patients appear
sleepy and confused. Speech is slow and inarticulate. Delusions and hallucinations
sometimes occur as well as seizures. Reflexes are often hyperactive, and extensor plantar
responses are encountered. Tremulousness is common, and muscle tone may be
increased. Spontaneous myoclonic jerks are occasionally observed at the bedside.
Typically, pupillary light reflexes and oculovestibular responses are preserved.
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