What Is Altered Sensorium (Confusion)?

What are the Common Causes of Altered Sensorium?

Reasons of Altered Sensorium Include:

• Dehydration
• Hypoglycemia (low blood sugar)
• Electrolyte imbalances
• Hypoxia (low oxygen levels)
• Fever (especially in children and elderly)
• Drug or alcohol intoxication
• Medication side effects
• Sleep deprivation
• Head trauma
• Withdrawal from substances

Conditions That Cause Altered Sensorium

• Stroke: A sudden interruption of blood flow to the brain that can cause confusion, disorientation, or loss of consciousness depending on the area affected.
• Meningitis or Encephalitis: Infections of the brain or its coverings that lead to inflammation, resulting in headache, fever, and altered mental status.
• Sepsis: A severe body-wide response to infection that can reduce blood flow to the brain, causing confusion or unresponsiveness.
• Liver Failure (Hepatic Encephalopathy): The buildup of toxins like ammonia due to poor liver function can impair brain activity, leading to confusion or coma.
• Kidney Failure (Uremic Encephalopathy): Accumulation of waste products in the blood from kidney dysfunction can affect brain function and cause mental changes.
• Brain Tumors: Growths in the brain can increase pressure or damage brain tissue, leading to symptoms like confusion, memory loss, or unconsciousness.
• Alzheimer's Disease or Other Dementias: Progressive brain disorders that gradually impair memory, judgment, and awareness, sometimes leading to altered sensorium.
• Delirium: A sudden and severe confusion often triggered by illness, surgery, or medication in older adults, marked by rapid changes in brain function.
• Psychosis or Acute Psychiatric Disorders: Mental health conditions like schizophrenia can distort perception and awareness, sometimes mimicking altered sensorium.
• Diabetic Ketoacidosis (DKA): A complication of uncontrolled diabetes where high blood sugar and ketone buildup cause confusion, fruity breath odor, and unconsciousness if untreated.

What are the Symptoms of Altered Sensorium?

An alteration in mental status refers to general changes in brain function, such as;

• Confusion
• Amnesia
• Loss of alertness
• Disorientation
• Poor judgment or thinking
• Unusual or strange behavior
• Poor regulation of emotions
• Disturbances in perception, psychomotor skills, and behavior.

While an altered mental state is characteristic of several psychiatric and emotional conditions, medical conditions and injuries that cause brain damage, including alcohol or drug overdoses and withdrawal syndromes, can also cause changes in the mental state.

When to Seek Medical Help for Altered Sensorium

While temporary confusion or drowsiness may resolve on its own, prompt medical attention is crucial if you observe

• Unconsciousness or inability to wake someone
• Sudden confusion with stroke signs (slurred speech, facial droop, limb weakness)
• High fever + stiff neck (possible meningitis)
• Seizures or violent tremors
• Severe breathing difficulties

Red Flags in High-Risk Groups

• For elderly/chronically ill: Even mild delirium warrants evaluation
• Post-surgery patients: New confusion could signal complications
• Medication users: Especially opioids, sedatives, or recent dose changes

How to Diagnosis Altered Sensorium?

• It is important to correctly diagnose the underlying cause of excessive sleepiness to establish the best treatment.
• During the diagnostic procedure, a doctor may ask questions about a person's lifestyle, medications, and mental health.
• In some cases, a physician may order the following diagnostic tests:
• A sleep study called polysomnography: This test records a person's brain waves, oxygen levels, and body movements during sleep to assess their sleep cycle.
• Electroencephalogram: This non-invasive test records electrical activity in the brain.

Treatment and Management for Altered Sensorium

• Identify and treat the underlying cause, such as infections, organ failure, stroke, or metabolic imbalances.
• Administer IV fluids and electrolytes if dehydration or imbalance is present.
• Provide oxygen therapy in cases of hypoxia or breathing difficulty.
• Use medications like antibiotics (for infections), antiepileptics (for seizures), or insulin (for diabetic ketoacidosis).
• Hospitalization and monitoring in severe cases to stabilize the patient and prevent complications.
• Neurological evaluation to assess and manage brain-related conditions like stroke or encephalopathy.

Prevention of Altered Sensorium

• Manage chronic conditions such as diabetes, liver disease, and kidney disorders effectively.
• Avoid alcohol and drug abuse, and use medications only as prescribed.
• Get vaccinated against infections like meningitis and influenza that can affect the brain.
• Ensure proper hydration and nutrition, especially in the elderly and medically vulnerable.
• Monitor and treat infections promptly to prevent them from progressing to sepsis.
• Control high blood pressure and cholesterol to reduce the risk of stroke.
• Regular medical checkups for early detection of systemic or neurological issues.

What are Home Remedies for Altered Sensorium?

Here are some tips or remedies for Altered Sensorium:

• Give your eyes a break to avoid exhaustion
• Eat a healthy snack to increase your energy
• Start a conversation to awaken your mind
• Take a breath to feel alert
• If you are driving, stop when you are sleepy
• Change tasks to stimulate your mind
• Drink water to prevent tiredness
• Get some natural light to regulate your sleep cycles
• Exercise to increase energy and reduce fatigue

Lifestyle Changes for Altered Sensorium

• Follow a well-balanced, nutrient-rich diet to support brain and organ function.
• Maintain good sleep hygiene to ensure consistent rest and prevent confusion.
• Avoid stress and overexertion, as these can worsen mental clarity.
• Stay mentally active through reading, puzzles, or engaging conversations.
• Limit exposure to environmental toxins or hazardous chemicals that may affect brain function.
• Keep track of medication schedules to avoid missed doses or overdoses.
• Use assistive devices or alarms if memory or orientation problems are frequent.