Consciousness - decreased

Definition

Decreased consciousness is reduced alertness or awareness.

Alternative Names

Considerations

A persistent coma is called vegetative state.

Common Causes

Many conditions can cause decreased consciousness, including:

• Alcohol or drug intoxication
• Arrhythmia
• Central nervous system diseases
• Decreased oxygen (hypoxia)
• Diabetic coma
• Electrolyte imbalance
• Exposure to heavy metals or hydrocarbons
• Extreme fatigue or sleep deprivation
• Ketoacidosis
• Head trauma
• Heart failure
• Hypoglycemia
• Infection
• Low blood pressure (hypotension)
• Metabolic problems
• Seizures such as those related to epilepsy
• Shock
• Stroke

Home Care

A decrease in consciousness almost always require a doctor's attention, except perhaps when due to alcohol intoxication, simple fainting, or a previously recognized seizure disorder.

See the article on seizures for tips on how to care for a person who is having a seizure.

Persons with epilepsy or other seizure disorder should carry a Medic-Alert bracelet or pendant stating that they have the condition. Avoid any circumstance that has previously triggered a seizure.

Call your health care provider if

See medical help if someone has unexplained, decreased consciousness. Call your local emergency number (such as 911) if normal consciousness does not return quickly.

What to expect at your health care provider's office

The doctor will perform a physical examination. The exam will include a detailed look at the cardiovascular and nervous system.

The health care team will ask questions about the person's medical history and symptoms, including

• Time pattern
  • When did the decreased consciousness occur?
  • How long did it last?
  • Has it ever happened before? If so, how many times?
  • Did the person behave the same way on previous episodes?
• Medical history
  • Does the person have known epilepsy or seizure disorder?
  • Does the person have diabetes?
  • Has the person been sleeping well?
  • Has there been a recent head injury?
• Other
  • What medications does the person take?
  • Does the person habitually use alcohol or drugs?
  • What other symptoms are present?

Tests that may be done include:

• Complete blood count or blood differential
• Electrolyte panel
• CT scan or MRI of the head
• ECG
• EEG
• Chest x-ray
• Urinalysis

Treatment depends on the underlying cause of the decreased consciousness.