Symptoms and Signs - Differential Diagnosis of Encephalopathy
• Akinetic mutism: these patients do not talk and do not move; there is little fluctuation in their state, and there is no asterixis. • Aphasia: distinguished from encephalopathy by virtue of its representing a specific disorder of language rather than a global disturbance of cognitive function. • Dementia: distinguished from encephalopathy by a history of slowly progressive cognitive decline over time (fluctuating cognitive function is rare except in diffuse Lewy body disease). • Depression • Hypersomnia • Locked-in syndrome: may be distinguished from encephalopathy by the presence of fixed neurologic deficits (e.g., paralysis of all four limbs). • Mania • Psychosis: some overlap with encephalopathy because delusions and hallucinations may be common to both. • Vegetative state from cerebral injury; these patients appear awake (eyes are open), but there is no content to their consciousness.
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