The Clinical Problem Solvers Episode 386: Neurology VMR – Confusion
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Mar 29, 2025 Dr. Sebastian Green, a neurology resident from UCLA with a strong foundation in neuroscience, delves into a fascinating case of confusion in a patient. He and his colleagues dissect the complexities of diagnosing confusion, exploring its neurological origins. They navigate the challenges posed by progressive dementia, emphasizing thorough patient history and neuroimaging. The discussion also covers critical insights into neurological examinations and the role of brain biopsies, highlighting the need for collaboration and innovative diagnostic approaches in neurology.
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Importance of Time Course in Confusion
- Confusion or altered mental status are common chief concerns in neurology.
- Time course is key to diagnosis, differentiating between sudden and gradual onset.
Differentiating Confusion from Focal Deficits
- Consider if confusion is a global state like delirium or a focal cognitive deficit like aphasia.
- Investigate if the patient exhibits aphasia, amnesia, or apraxia, masked as confusion.
Medical vs. Neurological Confusion
- Most altered mental status consults have medical etiologies, not neurological ones.
- The brain can be affected by systemic illnesses, making these consults challenging.
