A clinical and investigative approach to the patient with diminished responsiveness.
This article elucidates a stepwise approach to the patient with an acute alteration in the content or level of consciousness. The article begins with a discussion of the spectrum of diminished responsiveness. It then details which aspects of the history are important in obtaining an evaluation of these patients and reviews the neurologic examination of the comatose patient. A brief overview of the neuroanatomical localization of consciousness is provided. The differential diagnosis of diminished responsiveness is explored, followed by a discussion of the order and importance of laboratory, neuroimaging, and other ancillary tests.
Division of Critical Care Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Hocker.Sara@mayo.edu
Sara
S
Hocker
Alejandro A
AA
Rabinstein
D001921:Brain / Q000473:pathology*; D003244:Consciousness Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D003937:Diagnosis, Differential; D006801:Humans; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology; D059906:Neuroimaging; D010808:Physical Examination