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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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The diagnosis of encephalopathy begins with the history provided by the patient, family, or friends. The health care professional will have a better understanding about potential causes of the encephalopathy based upon information regarding symptoms, for example, how quickly they appeared, how long they have been present, whether they wax and wane, or whether there is a progressive downward course. Past history of medical illness, intentional or unintentional ingestions, prescribed medications, chemical exposure, and infections may provide clues as to why the patient has encephalopathy.

Testing will depend upon the patient's history and physical examination that lead the health care professional to look for potential diagnoses. Routine blood tests such as a complete blood count (CBC) may provide information about possible infection, anemia, or vitamin deficiency. Chemistry tests can evaluate electrolytes, glucose levels, kidney function, and liver function. Other tests may be ordered for different types of vitamin deficiencies. If appropriate, drug and alcohol screening may be suggested.

Imaging studies such as X-rays, computerized tomography (CT), and magnetic resonance imaging (MRI) may be useful depending upon the clinical situation.

Lumbar puncture (spinal tap) may be helpful to look for infection, bleeding, and inflammation. The cerebrospinal fluid can also be analyzed for abnormal proteins, chemicals, and cells.

Other testing may be appropriate depending upon the clinical situation and the suspicions of the health care practitioner.

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