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APPROACH TO THE PATIENT Disorders of Consciousness

Disorders of consciousness are common; these always signify a disorder of the nervous system. Assessment should determine the level of consciousness (drowsy, stuporous, comatose) and/or content of consciousness (confusion, perseveration, hallucinations). Confusion is a lack of clarity in thinking with inattentiveness; delirium is used to describe an acute confusional state; stupor, a state in which vigorous stimuli are needed to elicit a response; coma, a condition of unresponsiveness. Pts in such states are usually seriously ill, and etiologic factors must be assessed (Tables 18-1 and 18-2).

TABLE 18-1Common Etiologies of Delirium
TABLE 18-2Stepwise Evaluation of a Pt with Delirium

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