Abstract
An altered level of consciousness is an important clinical entity in pediatrics and carries the potential for significant morbidity and mortality. The clinician must assess the level of consciousness rapidly as well as determine likely causes. Structural or medical causes usually can be differentiated through a focused history and physical examination. Asymmetric neurologic findings such as a dilated and fixed pupil, dyscongugate extraocular movements, and asymmetric motor findings suggest brainstem dysfunction as a result of a structural lesion; slowly progressive but symmetric neurologic findings usually result from a medical disorder. Specific neurologic findings associated with elevated intracranial pressure are seen in both central and uncal herniation. Disorders of metabolism, liver, kidneys, lungs, or heart as well as toxic exposure are common medical causes for alteration of consciousness. After initial assessment and stabilization, management centers on determining the specific diagnosis and continuing supportive care.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 331-338 |
| Number of pages | 8 |
| Journal | Pediatrics in Review |
| Volume | 27 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2006 |
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ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
Altered states of consciousness. / Avner, Jeffrey R.
In: Pediatrics in Review, Vol. 27, No. 9, 09.2006, p. 331-338.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Altered states of consciousness
AU - Avner, Jeffrey R.
PY - 2006/9
Y1 - 2006/9
N2 - An altered level of consciousness is an important clinical entity in pediatrics and carries the potential for significant morbidity and mortality. The clinician must assess the level of consciousness rapidly as well as determine likely causes. Structural or medical causes usually can be differentiated through a focused history and physical examination. Asymmetric neurologic findings such as a dilated and fixed pupil, dyscongugate extraocular movements, and asymmetric motor findings suggest brainstem dysfunction as a result of a structural lesion; slowly progressive but symmetric neurologic findings usually result from a medical disorder. Specific neurologic findings associated with elevated intracranial pressure are seen in both central and uncal herniation. Disorders of metabolism, liver, kidneys, lungs, or heart as well as toxic exposure are common medical causes for alteration of consciousness. After initial assessment and stabilization, management centers on determining the specific diagnosis and continuing supportive care.
AB - An altered level of consciousness is an important clinical entity in pediatrics and carries the potential for significant morbidity and mortality. The clinician must assess the level of consciousness rapidly as well as determine likely causes. Structural or medical causes usually can be differentiated through a focused history and physical examination. Asymmetric neurologic findings such as a dilated and fixed pupil, dyscongugate extraocular movements, and asymmetric motor findings suggest brainstem dysfunction as a result of a structural lesion; slowly progressive but symmetric neurologic findings usually result from a medical disorder. Specific neurologic findings associated with elevated intracranial pressure are seen in both central and uncal herniation. Disorders of metabolism, liver, kidneys, lungs, or heart as well as toxic exposure are common medical causes for alteration of consciousness. After initial assessment and stabilization, management centers on determining the specific diagnosis and continuing supportive care.
UR - http://www.scopus.com/inward/record.url?scp=33750942836&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33750942836&partnerID=8YFLogxK
U2 - 10.1542/pir.27-9-331
DO - 10.1542/pir.27-9-331
M3 - Article
VL - 27
SP - 331
EP - 338
JO - Pediatrics in Review
JF - Pediatrics in Review
SN - 0191-9601
IS - 9
ER -