Altered mental status (AMS) and altered level of consciousness (ALOC) refer to events that occur in a person’s mental state. An individual’s normal mental state of consciousness can be divided into two: arousal and cognition. Arousal is controlled by the brainstem, which contains the reticular activating system (RAS). Any derangements in arousal show up as symptoms of depression (lethargy, stupor, and coma) or elevation (agitation, hypervigilance, or even a seizure). Derangements in cognition, on the other hand, can present themselves as confusion, amnesia, hallucination, and detachment from reality.
It has also been noted that damage to a person’s brainstem, which can be in the form of isolated structural lesions (ischemic stroke or hemorrhage), can lead to disruption of a person’s RAS and decrease the level of consciousness. Other common causes of altered mental status include the following: metabolic derangements; poisonings; and conditions that affect both hemispheres of the brain (CNS infections or increased intracranial pressure).
However, there are some focal neurological deficits that have been confused as being alterations in consciousness. Here is a list of just some of the mistaken alterations:
- Spatial neglect syndromes
- Hemianopsias and hemiparesis
- Dysarthrias and aphasias (receptive, motor or mixed)
ER Centers specializes in all manners of altered mental status and behavior. Contact us to get a consultation regarding your mental health.