Altered Mental Status - Neonatal Disorders

What is Altered Mental Status in Pediatrics?

Altered mental status (AMS) in pediatrics refers to a change in a child's baseline cognitive function or consciousness. This can range from mild confusion to complete unresponsiveness. It is a symptom, not a diagnosis, and indicates an underlying condition that requires immediate attention.

What Causes Altered Mental Status in Children?

Several factors can cause AMS in children, including:

Infections such as meningitis, encephalitis, and sepsis
Metabolic disturbances like hypoglycemia, hyperglycemia, and electrolyte imbalances
Traumatic brain injury
Seizures or postictal states
Ingestions or poisonings
Psychiatric conditions such as acute psychosis
Hypoxia or respiratory failure

What are the Symptoms of Altered Mental Status?

Symptoms of AMS can vary widely but may include:

Confusion or disorientation
Lethargy or excessive sleepiness
Agitation or irritability
Decreased responsiveness or unresponsiveness
Changes in behavior or personality
Difficulty in speaking or understanding speech

How is Altered Mental Status Diagnosed?

Diagnosis involves a thorough medical history and physical examination. Key steps include:

Assessing the child's vital signs
Performing a neurological examination
Obtaining a history of recent illnesses, injuries, or exposures
Laboratory tests to check for metabolic disturbances, infections, or toxins
Imaging studies like CT or MRI to look for structural brain abnormalities
Spinal tap if meningitis or encephalitis is suspected