Obtundation
Key points
- Decreased consciousness refers to diminished alertness or awareness.
- Decreased consciousness may result from a multitude of conditions including intoxication (drug, alcohol, or toxin), metabolic abnormalities, seizure activity (epilepsy), central nervous system diseases and conditions, head trauma, shock, decreased oxygen (hypoxia), and decreased blood pressure (hypotension).
- In the event of a seizure (in someone else), loosen clothing, lay the person flat, and protect the person from injury by moving furniture and other objects out of the area.
- The medical history will be obtained and a physical examination performed.
Alternative names
Stuporous; Mental status - decreased; Loss of alertness; Decreased consciousness; Alertness - decreased; Changes in consciousness; Consciousness - decreased; Coma
Definition
Decreased consciousness refers to diminished alertness or awareness.
Considerations
Decreased consciousness may result from a multitude of conditions including intoxication (drug, alcohol, or toxin), metabolic abnormalities, seizure activity (epilepsy), central nervous system diseases and conditions, head trauma, shock, decreased oxygen (hypoxia), and decreased blood pressure (hypotension).
Decrease in consciousness, unconsciousness, and coma almost always require medical evaluation (with the possible exception of alcohol intoxication, simple fainting, or a previously recognized seizure disorder).
Persistent coma is called vegetative state.
Common Causes
- head trauma
- extreme fatigue or sleep deprivation
- seizure activity
- stroke (CVA)
- heart failure
- arrhythmia
- diabetic coma (diabetic hyperglycemic hyperosmolar coma)
- hypoglycemia
- ketoacidosis
- head injury
- drug intoxication (for example, from pain killers, anticonvulsants, antihistamines, benzodiazepines, digoxin, ethanol (see ethanol overdose), heavy metals, hydrocarbons, barbiturates, insulin, lithium, organophosphates, phencyclidine, phenothiazines - oral, salicylates - oral, or tricyclic antidepressants)
- electrolyte abnormality (hypernatremia, hypercalcemia)
- infection
Home Care
In the event of a seizure (in someone else), loosen clothing, lay the person flat, and protect the person from injury by moving furniture and other objects out of the area. Although frightening, seizures are rarely harmful.
For decreased consciousness caused by seizures (epilepsy), carry a Medic-Alert bracelet or pendant stating that you have a seizure disorder (in case you have a seizure in the future). Avoid any circumstance that has previously triggered a seizure.
For decreased consciousness due to a known medical condition or for unexplained decrease in consciousness consult your physician.
Follow prescribed treatment.
Call your health care provider if
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.