Encephalopathies represent diffuse multifocal cerebral states which may be caused by many organ dysfunctions and factors.In general they represent functional disturbances of the brain and these are at least in the beginning not combined with morphological correlates.
Most common encephalopathies encountered in the hospital will be metabolic or hepatic, but many more can exist.
Below is a listing of most etiologies of encephalopathies.
Hypoxia
– Anemia
– Pulmonary disease
– Alveolar hypoventilation
Ischemia
– Cardivascular disease (including cardiac arrest)
– Stokes-Adams syndrome, cardiac arrythmias
– Hypersensitive carotid sinus
– Microvascular diseases
– Hyperviscosity syndrome
– Hypotension
– Hypertension
Systemic diseases
– Hepatic disease
– Renal disease
– Pancreatic disease (gastrointestinal)
– Malnutrition (vitamin deficiency)
– Endocrine dysfunction (hypoglycemia or hyperglycemia and hyperosmolar
state)
– Acid – base, electrolyte, and fluid imbalances
– Vasculitis
– Infections and sepsis
– Malignancy (paraneoplastic syndromes)
Toxic agents
– Alcohol, sedatives (barbiturates, narcotics, tranquilizers)
– Psychiatric medications (tricyclic antidepressants, anticholinergic, drugs,
phenothiazine, MAO-inhibitors)
– Heavy metals
– Organic phosphates, solvents
– Other drugs (corticosteroids, penicillin, anticonvulsants)
Remember that the term " Altered mental status" is only a symptom, describing that the patient is exhibiting some sort of disruption in cognitive function, which, in many cases, is an encephalopathy that needs to be well documented, even if it is brief in duration.
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