Alertness - decreased

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Stuporous; Mental status - decreased; Loss of alertness; Decreased consciousness; Changes in consciousness; Obtundation; Coma; Unresponsiveness

Get medical help for any decrease in consciousness, even when it is due to alcohol intoxication, fainting, or a seizure disorder that has already been diagnosed.

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 describing their condition. They should avoid situations that have triggered a seizure in the past.

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Get medical help if someone has decreased alertness that cannot be explained. Call your local emergency number (such as 911) if normal alertness does not return quickly.

Most often, a person with decreased consciousness will be evaluated in an emergency room.

The doctor will perform a physical examination. The exam will include a detailed look at the heart, breathing, 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 alertness happen?
  • How long did it last?
  • Has it ever happened before? If so, how many times?
  • Did the person behave the same way during past episodes?
• Medical history
  • Does the person have epilepsy or a 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 use alcohol or drugs on a regular basis?
  • What other symptoms are present?

Tests that may be done include:

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

Treatment depends on the cause of the decreased alertness. How well a person does depends on the cause of the condition. The longer the person has had decreased alertness, the worse the outcome.

Review Date: 04/03/2011
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).