Neurological diseases

Neurological Disorders
Coma
is a state of complete behavioral unresponsiveness to external stimulation. Because some causes of coma may lead to irreversible brain damage, expeditious evaluation and treatment should be performed concurrently.
Acute confusional state (delirium)
Diffuse or multifocal cerebral dysfx & c.c.c by relatively rapid reduction in the ability to focus, sustain, or shift attention, a change in cognition, fluctuations in consciousness; disorientation and sometimes hallucinations.
Coma results from diffuse or multifocal dysfunction within cerebral hemispheres or the reticular activating system in the brainstem.







Diagnosis
? History of trauma, seizures, medication changes, alcohol, drug, existing medical conditions.
? Trauma(immobilize the spine immediately while arranging radiographs (fracture or instability).
? Signs of systemic illness associated with coma (e.g., cirrhosis, hemodialysis shunt, rash of meningococcemia) or signs of head trauma (e.g., lacerations, periorbital or mastoid ecchymosis, hemotympanum).
? The physical and neurologic examination may reveal systemic illness (e.g., pneumonia) or neurologic signs (meningismus or paralysis) to narrow the differential diagnosis.
? The diagnosis of brain herniation must be recognized
? Repeated neurologic examination, Level of consciousness (Glasgow Coma Scale. 3 (unresponsive) to 15 (normal).