obtundation

Obtundation refers to less than full mental capacity in a medical patient, typically as a result of a medical condition or trauma.

Obtundation is progressive as serum calcium concentrations increase and may progress to stupor or coma.

One week postoperatively, he developed ataxia followed by confusion, tremulousness, dysarthria, and obtundation.

The diagnosis is usually discovered when a chemistry screen performed because of obtundation reveals extreme hyperglycemia (often above 1800 mg/dl (100 mM)) and dehydration.

Nonketotic hyperosmolar coma usually develops more insidiously than DKA because the principal symptom is lethargy progressing to obtundation, rather than vomiting and an obvious illness.

Fatal cases continue to deteriorate, experiencing continued fever, obtundation, coma, convulsions, diffuse coagulopathy, metabolic disturbances, shock and death, with death typically occurring between Days 8 and 16.

Severe cases are characterized by either obtundation (dulled consciousness) or the combination of elevated bilirubin levels and prolonged prothrombin time; the mortality rate in both categories is 50% within 30 days of onset.

For instance, severe hypoglycemia (low blood sugar) or hypercapnia (increased carbon dioxide levels in the blood) initially cause mild agitation and confusion, but progress to obtundation, stupor and finally complete unconsciousness.

One author observed that malaise and fatigue were the most common complaints at patient presentation, followed by (in order of decreasing prevalence rate) varying degrees of obtundation, anorexia, pain, polyuria-polydipsia, constipation, nausea, and vomiting.

Some objective measurement of cerebral function can be frequently and rapidly assessed before the patient undergoes therapeutic obtundation, or specifically neuromuscular blockade, then the effects of sedation can be followed in real time (Figs 2and 3).