Altered Mental Status

Altered mental status most often refers to an abnormal change in your responsiveness and awareness. It can affect your speech, thought, mobility, memory, attention span, or alertness. It can range from slight confusion to complete unresponsiveness (coma). Altered mental status can be a sign of a serious underlying medical condition. Rapid evaluation and medical treatment is necessary for patients having an altered mental status.


  • Low blood sugar (hypoglycemia) or diabetes.

  • Severe loss of body fluids (dehydration) or a body salt (electrolyte) imbalance.

  • A stroke or other neurologic problem, such as dementia or delirium.

  • A head injury or tumor.

  • A drug or alcohol overdose.

  • Exposure to toxins or poisons.

  • Depression, anxiety, and stress.

  • A low oxygen level (hypoxia).

  • An infection.

  • Blood loss.

  • Twitching or shaking (seizure).

  • Heart problems, such as heart attack or heart rhythm problems (arrhythmias).

  • A body temperature that is too low or too high (hypothermia or hyperthermia).


A diagnosis is based on your history, symptoms, physical and neurologic examinations, and diagnostic tests. Diagnostic tests may include:

  • Measurement of your blood pressure, pulse, breathing, and oxygen levels (vital signs).

  • Blood tests.

  • Urine tests.

  • X-ray exams.

  • A computerized magnetic scan (magnetic resonance imaging, MRI).

  • A computerized X-ray scan (computed tomography, CT scan).


Treatment will depend on the cause. Treatment may include:

  • Management of an underlying medical or mental health condition.

  • Critical care or support in the hospital.


  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Manage underlying conditions as directed by your caregiver.

  • Eat a healthy, well-balanced diet to maintain strength.

  • Join a support group or prevention program to cope with the condition or trauma that caused the altered mental status. Ask your caregiver to help choose a program that works for you.

  • Follow up with your caregiver for further examination, therapy, or testing as directed.


  • You feel unwell or have chills.

  • You or your family notice a change in your behavior or your alertness.

  • You have trouble following your caregiver's treatment plan.

  • You have questions or concerns.


  • You have a rapid heartbeat or have chest pain.

  • You have difficulty breathing.

  • You have a fever.

  • You have a headache with a stiff neck.

  • You cough up blood.

  • You have blood in your urine or stool.

  • You have severe agitation or confusion.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.