BACKGROUND AND PURPOSE The aim of this study was to characterize the response of the hypothalamic-pituitary-adrenal system in the first hours of ischemic stroke and to relate its extent to the occurrence of acute confusional state, volume of brain damage, and clinical outcome. METHODS The secretion of corticotropin (adrenocorticotropic hormone [ACTH]) and cortisol was studied in 23 patients b...

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare condition characterized by emotional and behavioral disturbances, dyskinesias, and extrapyramidal signs. It occurs in young women of reproductive age and is classically described as a paraneoplastic phenomenon. We present a 36-year-old, HIV-positive female who was admitted to the hospital in an acute confusional state, with ...

KEY CLINICAL MESSAGE In-hospital hanging during a confusional state from alcohol intoxication is rare. To treat cases of acute alcohol intoxication, careful observation will be needed to avoid accidental psychological reactions.

Nonconvulsive status epilepticus (NCSE) is a medical emergency, which is diagnosed most frequently with the routine use of EEG in the pediatric emergency and intensive care units. Data from eight patients, ranging from 2.8-15 years old (median 8.7 years), treated with the diagnosis of NCSE were evaluated on clinical basis. The patients attended the hospital with acute confusional state ranging ...

UNLABELLED  Introduction and aim. Liver disease is associated with cognitive dysfunction also at early stages, and minimal hepatic encephalopathy, affecting 20-70% of patients, is frequently under-recognized. The main purpose of this work was to demonstrate that a substantial number of patients, enrolled due to an acute confusional state in absence of a diagnosis of liver disease, suffers of he...

OBJECTIVE To describe a patient with unusually good outcome of a rare, high-grade lymphoma that often involves the nervous system. DESIGN Case report. SETTING University hospital. CASE A 70-year-old pharmacist first presented with meningoencephalitislike symptoms and 6 months later with acute confusional state followed by complex partial status epilepticus. Diagnosis of intravascular lymp...

Confusion is a rare manifestation of thyrotoxicosis. The patient presented with an acute confusional state and had clinical and biochemical features of thyrotoxicosis. His illness was well controlled with antithyroid therapy. It is thus concluded that thyroid function should be evaluated in otherwise unexplained encephalopathy as response to treatment is dramatic and most rewarding.