Possible Causes for somnolence Acute Alcohol Intoxication Somnolence, stupor, disorientation and disturbance of balance are common and well recognized symptoms of the depression of the central nervous system (CNS) related to alcohol [academic.oup.com] Patients are generally calm and somnolent," said Blatman. "Let them stay that way by avoiding arguments or provocation." [ems1.com] Consciousness was assessed on a scale from normal (1 point) to severely aggravated (4 points): clear consciousness, disorientation, somnolence, stupor or coma (estimated on [academic.oup.com] Hypoglycemia confusion, behavioral changes, somnolence). [amboss.com] Nocturnal attacks are often preceded by nightmares and cause severe sleep disturbance resulting in daytime somnolence. Only a perfect diet will control hypoglycemia. [fibromyalgiatreatment.com] This is seen in people with diabetes treated with insulin who may show reduction in spontaneous movements and speech, somnolence, poor thinking and work performance, changes [patient.info] Restless Legs Syndrome Placebo comparisons showed a significantly higher incidence of nausea for pramipexole (p 0.01), whereas nausea, vomiting, dizziness, and somnolence were significantly higher [ncbi.nlm.nih.gov] The main side effects were dizziness, somnolence, headache, and irritability. [ncbi.nlm.nih.gov] Its most common adverse effects include somnolence and dizziness. [msdmanuals.com] Hyponatremia This lady’s urgent admission to hospital was prompted by somnolence following an intentional overdose (7,500 mg) of her sodium valproate medication. [acutecaretesting.org] They include: headache nausea, loss of appetite, vomiting malaise lethargy weakness poor coordination muscle cramps somnolence disorientation personality change Physical Exam [sharinginhealth.ca] The patient was noted to be somnolent and confused. Table 1 summarizes the patient's laboratory data on admission. Table 1. [clinchem.aaccjnls.org] Morbid Obesity This can be spectacularly effective in relieving right heart failure, day-time somnolence, and pulmonary hypertension. [academic.oup.com] An apnoeic episode is defined as 10 s or more of total cessation of airflow, despite continuous respiratory effort against a closed airway; snoring; day-time somnolence, associated [academic.oup.com] Thrombocytopenia Findings suggestive of intracranial hemorrhage include the following: Headache, blurred vision, somnolence, or loss of consciousness Hypertension and bradycardia, which may [emedicine.medscape.com] […] thrombocytopenia and a relatively low risk for a serious bleeding complication Findings suggestive of intracranial hemorrhage include the following: Headache, blurred vision, somnolence [emedicine.medscape.com] Bronchial Asthma With advanced hypercarbia, bradypnea, somnolence, and profuse diaphoresis may be present; almost no breath sounds may be heard; and the patient is willing to lie recumbent [emedicine.medscape.com] Obstructive Sleep Apnea Neither patient exhibited daytime somnolence, although both were subsequently found to have severe obstructive sleep apnea. [ncbi.nlm.nih.gov] A 55-year-old woman who presented to the sleep clinic with severe sleep apnea (OSA) (apnea-hypopnea index [AHI] 62) and excessive somnolence (Epworth Sleepiness Scale score [ncbi.nlm.nih.gov] Our patient was screened with full polysomnography because of heavy snoring, daytime somnolence and obesity. It revealed severe obstructive sleep apnea syndrome. [ncbi.nlm.nih.gov] Sleep Apnea In epilepsy patients with risk factors (eg, obesity) or markers (eg, habitual snoring, daytime somnolence) for sleep apnea, a careful sleep history should be elicited and [ncbi.nlm.nih.gov] During last year, the patient was accusing excessive daytime somnolence, breath arrests during sleep, intense snoring, morning headaches, morning oral dryness, pin point chest [ncbi.nlm.nih.gov] […] although clinical reports of SDB were first made in the 19th century. 1 Likely influenced by such observations, descriptions of an entity constituting obesity and extreme somnolence [accessmedicine.mhmedical.com] Iron Deficiency Anemia INTRODUCTION Iron deficiency anemia (IDA) is a common complication in routine clinical practice that frequently originates in the gastrointestinal (GI) tract[ 1 - 3 ]. Patients with IDA are therefore often referred to gastroenterologists for further examination and/or treatment. IDA associated with GI disorders can[…] [dx.doi.org] Brain Concussion Neuroimaging Clin N Am. 2018 Feb;28(1):15-29. doi: 10.1016/j.nic.2017.09.006. Epub 2017 Oct 27. Author information 1 Diagnostic and Interventional Imaging Department, El Bosque University, Hospital Universitario Fundacion Santa Fe de Bogota, Calle 119 # 7 - 75, Bogota DC 110111, Colombia. Electronic address:[…] [ncbi.nlm.nih.gov] Atrial Fibrillation We report a previously healthy 58-years old female, admitted because of nausea, dizziness, somnolence, a left-sided hemiparesis and arterial hypotension. [ncbi.nlm.nih.gov] Chronic Kidney Insufficiency Abstract Anemia is a major problem in patients with chronic kidney insufficiency. The development of recombinant human erythropoietin has enabled physicians to correct this anemia. Although anemia has not been considered to be a common or important contributor to congestive heart failure, anemia of any cause can[…] [ncbi.nlm.nih.gov] Stroke The therapeutic window for intervention in acute cerebral ischemia is brief. Prehospital identification of acute stroke patients and paramedic administration of neuroprotective agents may soon become critical components of successful acute stroke treatment. This preliminary study sought to demonstrate that a new[…] [ncbi.nlm.nih.gov] Sepsis To define the terms "sepsis" and "organ failure" in a precise manner. Review of the medical literature and the use of expert testimony at a consensus conference. American College of Chest Physicians (ACCP) headquarters in Northbrook, IL. Leadership members of ACCP/Society of Critical Care Medicine (SCCM). An[…] [ncbi.nlm.nih.gov] Dehydration […] grave.Échelle clinique de déshydratation 012 Apparence généraleNormaleL’enfant a soif, il est agité ou il est léthargique, mais irritable lorsqu’on le toucheL’enfant est somnolent [aboutkidshealth.ca] […] suffisamment de liquides pour combler la perte des fluides;il n’a pas uriné depuis plus de 6 heures (s’il est un bébé) ou 12 heures (s’il est un tout-petit);il est très somnolent [aboutkidshealth.ca] […] uriner une plus petite quantité de liquide qu’à l’habitude, ne pas uriner du tout pendant une période de 8 à 12 heures ou produire une urine de couleur foncée;présenter de la somnolence [aboutkidshealth.ca] Hypoxia Subjective symptoms may include fatigue, lassitude (state of exhaustion), somnolence (drowsiness, sleepiness), dizziness, headache, breathlessness, and euphoria. [mountainflying.com] Such history may include (but should not be limited to) habitual snoring with gasping, daytime somnolence, and presence of tonsillar and adenoidal hypertrophy on examination [bloodjournal.org] Cinchonism Large doses of quinine may lead to severe (but reversible) symptoms of cinchonism: skin rashes, deafness, somnolence, diminished visual acuity or blindness, anaphylactic shock [en.wikipedia.org] Large doses of quinine may lead to severe symptoms of cinchonism : skin rashes, deafness (reversible), somnolence, diminished visual acuity or blindness, anaphylactic shock [diki.pl] Large doses of quinine may lead to severe symptoms of cinchonism: skin rashes, deafness, somnolence, diminished visual acuity or blindness, anaphylactic shock, and disturbances [academickids.com] Subdural Hematoma Patients with chronic subdural hematoma (CSDH) typically present with symptoms of increased intracranial pressure, including headache, nausea/vomiting, and somnolence, or [ncbi.nlm.nih.gov] 9.2 median 52.0 males (n 19) mean age SD (yrs) 48.1 9.7 median age 51.0 females (n 8) mean age SD (yrs) 53.1 7.1 median age 55.5 leading symptoms (multiple) headache 15 somnolence [doi.org] Hepatic Encephalopathy Clinically overt HE includes personality changes, alterations in consciousness progressive disorientation in time and space, somnolence, stupor and, finally, coma. [ncbi.nlm.nih.gov] […] addition Grade 2 Lethargy or apathy Minimal disorientation for time or place Subtle personality change Inappropriate behavior Impaired performance of subtraction Grade 3 Somnolence [aafp.org] Back to the Case Our patient has severe HE manifested by worsening somnolence. [the-hospitalist.org] Epidural Hematoma The exam may also show signs of increased ICP, such as: Headaches Somnolence Confusion Nausea and vomiting If there is increased ICP, emergency surgery may be needed to relieve [nlm.nih.gov] […] can result in clinically significant morbidity and/or mortality if it is not diagnosed and treated promptly. [1, 2] EDH is considered a neurosurgical emergency in which somnolence [emedicine.medscape.com] Acute Respiratory Distress Syndrome History Acute respiratory distress syndrome (ARDS) is characterized by the development of acute dyspnea and hypoxemia within hours to days of an inciting event, such as trauma, sepsis, drug overdose, massive transfusion, acute pancreatitis, or aspiration. In many cases, the inciting event is obvious, but, in others[…] [emedicine.medscape.com] Hydrocephalus […] healthy male patient, except for a history of two previous surgeries for ulnar nerve entrapment and progressive left upper extremity weakness, presented with acute onset somnolence [ncbi.nlm.nih.gov] Diabetes Mellitus Type 1 Children with diabetes mellitus (DM) type 1 may be at risk for iron deficiency (ID) although this has been little studied. ID is either an absolute (depleted iron stores) or a functional (restricted iron stores due to chronic inflammation) deficiency each requiring a different therapeutic approach. Unfortunately,[…] [ncbi.nlm.nih.gov] Diabetic Ketoacidosis Lethargy and somnolence are symptoms of more severe decompensation. [merckmanuals.com] Mental status can vary from somnolence to lethargy and coma. [aafp.org] Heroin Dependence Addict Biol. 2014 Jan;19(1):111-21. doi: 10.1111/j.1369-1600.2012.00445.x. Epub 2012 Apr 13. Nelson EC 1, Lynskey MT, Heath AC, Wray N, Agrawal A, Shand FL, Henders AK, Wallace L, Todorov AA, Schrage AJ, Madden PA, Degenhardt L, Martin NG, Montgomery GW. Author information 1 Department of Psychiatry, Washington University[…] [ncbi.nlm.nih.gov] Central Sleep Apnea Patients with hypercapnic forms may experience daytime somnolence (sometimes called wake-time sleepiness), lethargy, and morning headache. [merckmanuals.com] Gastaut and his collaborators in their report on the abnormal breathing patterns observed in a subtype of so-called "Pickwickian patients," morbidly obese subjects with somnolence [medlink.com] Morbidly obese with right heart failure and somnolence - Those on chronic opioids or with neuromuscular disease - Chronic heart failure and low EF -Refer to sleep specialist [quizlet.com] Multiple Myeloma Patients may report headaches and somnolence, and they may bruise easily and have hazy vision. [emedicine.medscape.com] The incidence of grade 3 or 4 somnolence, constipation, or peripheral neuropathy (all toxic effects of thalidomide) was less than 10% in the two groups and rarely resulted [content.nejm.org] Hypercalcemia Confusion, somnolence, bone pain, constipation, nausea, and thirst are the presenting symptoms of hypercalcemia. [emedicine.medscape.com] Acute Liver Failure The diagnosis of acute liver failure is actually based upon the appearance of clinical symptoms of hepatic encephalopathy, such as mental clouding, confusion, asterixis, somnolence [livertox.nih.gov] When he became somnolent, he was admitted to a district hospital, where he was found to be icteric and afebrile, with tachycardia but otherwise normal cardiac function, a [doi.org] […] anxiety, and decreased attention span; grade 2 is marked by disorientation, lethargy or asterixis; grade 3 is associated with marked disorientation, incoherent speech, and somnolence [clevelandclinicmeded.com] Myeloproliferative Disease […] transfusion requirements) in 29% of patients with moderate or severe anemia.37 However, a large number of patients stopped the drug secondary to side effects (neuropathy, somnolence [clevelandclinicmeded.com]
