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78: Altered Mental Status
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Published:May 2023
Meaghan Mungekar, MD, FAAP, "Altered Mental Status", Caring for the Hospitalized Child: A Handbook of Inpatient Pediatrics, American Academy of Pediatrics Section on Hospital Medicine, Jeffrey C. Gershel, MD, FAAP, Daniel A. Rauch, MD, FAAP, SFHM
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Altered mental status (AMS) is a derangement in consciousness and is defined as impaired arousal and awareness of one’s self and environment. Alteration of level of consciousness begins with becoming unaware of self, followed by reduced awareness of the environment, and finally an inability to be aroused. Awareness is determined by the cerebral hemispheres, whereas arousal is controlled by the ascending reticular activating system (ARAS). Although derangements in either one or both systems may alter mental status, there is a spectrum of decreasing states of consciousness, ranging from confusion (loss of clear thinking) to coma (no response to pain and...
