Metabolische Ursachen von Bewusstseinsstörungen

A wide variety of metabolic disorders may cause global cerebral dysfunction, so-called metabolic encephalopathy. Several pathophysiological mechanisms are involved. Clinical features are usually nonspecific and can range from subtle cognitive difficulties to loss of consciousness and sleep-like coma. Physical examination should focus on mental status, cranial nerve function, motor abnormalities, and features of autonomic instability. Basic laboratory results may point to the underlying cause; however, if inconclusive, cerebral imaging is strongly indicated. The most frequent causes of metabolic encephalopathy are electrolyte abnormalities, hypo- and hyperglycemia, adrenal and thyroidal endocrinopathies, as well as septic, hepatic, uremic, and Wernicke’s encephalopathy.