SCREENING FOR ORGANIC ILLNESS IN THE DISTURBED PATIENT

See Delerium/Acute confusional state
See Dementia

HISTORY

Past medical history - e.g. thyroid dysfunction, adrenal dysfunction, vasculitides/SLE, HIV/immune deficiencies, dementia, recurrent infections/

Medications/Recreational drugs - e.g. CNS depressants, alcohol, psychotropics, anticholinergics, opiates

Infective symptoms

Acute neurological symptoms - headache, photophobia, fits/faints/funny turns

EXAMINATION

Vital signs (PR, BP, SaO2, RR, Temp)

Orientation/Conscious state/GCS

Abnormal pupils - e.g. miotic, mydratic, unequal

Sweating

Neurological exam - especially nystagmus, focal neurology, ataxia, cerebellar dysfunction/incoordination

 

Any abnormalities of the above need to evaluated in more detail