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</div><div><span>Decreased alertness</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Decreased alertness</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Decreased alertness is a state of reduced awareness and is often a serious condition.</p><p>A coma is the most severe state of decreased alertness from which a person cannot be awakened. A long-term coma is called a vegetative state.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>Many conditions can cause decreased alertness, including:</p><ul><li><a test="test" href="./000471.htm">Chronic kidney disease</a></li><li>Extreme tiredness or lack of sleep</li><li><a test="test" href="../patientinstructions/000332.htm">High blood sugar</a> or <a test="test" href="./000386.htm">low blood sugar</a></li><li>High or low blood sodium concentration</li><li>Infection that is severe or involves the brain</li><li><a test="test" href="./000302.htm">Liver failure</a></li><li>Thyroid conditions that cause <a test="test" href="./000353.htm">low thyroid hormone levels</a> or <a test="test" href="./000356.htm">very high thyroid hormone levels</a></li></ul><p>Brain disorders or injury, such as:</p><ul><li><a test="test" href="./000739.htm">Dementia</a> or <a test="test" href="./000760.htm">Alzheimer disease</a> (advanced cases)</li><li>
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Head trauma (moderate to severe cases)</li><li><a test="test" href="./003200.htm">Seizure</a></li><li><a test="test" href="./000726.htm">Stroke</a> (usually when the stroke is either massive or has destroyed certain areas of the brain such as the brainstem or thalamus)</li><li>Infections that affect the brain, such as <a test="test" href="./000680.htm">meningitis</a> or <a test="test" href="./001415.htm">encephalitis</a></li></ul><p>Injury or accidents, such as:</p><ul><li>Diving accidents and near drowning</li><li><a test="test" href="./000056.htm">Heat stroke</a></li><li>Very low body temperature (<a test="test" href="./000038.htm">hypothermia</a>) </li></ul><p>Heart or breathing problems, such as:</p><ul><li>Abnormal heart rhythm</li><li>Lack of oxygen from any cause</li><li><a test="test" href="./007278.htm">Low blood pressure</a></li><li>Severe <a test="test" href="./000158.htm">heart failure</a></li><li>Severe lung diseases</li><li>Very <a test="test" href="./000468.htm">high blood pressure</a></li></ul><p>Toxins and drugs, such as:</p><ul><li>Alcohol use (binge drinking or damage from long-term alcohol use)</li><li>Exposure to heavy metals, hydrocarbons, or toxic gases</li><li>Overuse of drugs such as opiates, narcotics, sedatives, and anti-anxiety or seizure medicines</li><li>Side effect of almost any medicine, such as those used to treat seizures, depression, psychosis, and other illnesses</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Home Care</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Get medical help for any decrease in consciousness, even when it is due to alcohol intoxication, <a test="test" href="./003092.htm">fainting</a>, or a seizure disorder that has already been diagnosed.</p><p>People with epilepsy or other seizure disorders should wear a medical ID bracelet or necklace describing their condition. They should avoid situations that have triggered a seizure in the past.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Get medical help if someone has decreased alertness that cannot be explained. Call 911 or the local emergency number if normal alertness does not return quickly.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>What to Expect at Your Office Visit</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Most often, a person with decreased consciousness will be evaluated in an emergency room.</p><p>The health care provider will perform a <a test="test" href="./002274.htm">physical examination</a>. The exam will include a detailed look at the heart, breathing, and nervous system.</p><p>The health care team will ask questions about the person's medical history and symptoms, including:</p><p><strong>Time pattern</strong></p><ul><li>When did the decreased alertness happen?</li><li>How long did it last?</li><li>Has it ever happened before? If so, how many times?</li><li>Did the person behave the same way during past episodes? </li></ul><p><strong>Medical history</strong></p><ul><li>Does the person have epilepsy or a seizure disorder?</li><li>Does the person have <a test="test" href="./001214.htm">diabetes</a>?</li><li>Has the person been sleeping well?</li><li>Has there been a recent head injury? </li></ul><p><strong>Other</strong></p><ul><li>What medicines does the person take?</li><li>Does the person use alcohol or drugs on a regular basis?</li><li>What other symptoms are present? </li></ul><p>Tests that may be done include:</p><ul><li><a test="test" href="./003804.htm">Chest x-ray</a></li><li><a test="test" href="./003642.htm">Complete blood count (CBC)</a> or <a test="test" href="./003657.htm">blood differential</a></li><li><a test="test" href="./003786.htm">CT scan</a> or <a test="test" href="./003791.htm">MRI</a> of the head</li><li>Oxygen level (pulse oximetry or <a test="test" href="./003855.htm">blood gas</a>)</li><li><a test="test" href="./003868.htm">Electrocardiogram (ECG)</a></li><li><a test="test" href="./003931.htm">Electroencephalogram (EEG)</a></li><li>Metabolic panel and liver function tests</li><li>Toxicology panel and alcohol level</li><li><a test="test" href="./003579.htm">Urinalysis</a></li></ul><p>Treatment depends on the cause of the decreased alertness. How well a person does depends on the cause of the condition.</p><p>The longer the person has had decreased alertness, the worse the outcome.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Stuporous; Mental status - decreased; Loss of alertness; Decreased consciousness; Changes in consciousness; Obtundation; Coma; Unresponsiveness</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Patient Instructions</h2></div><div class="section-button"><button type="submit" aria-controls="section-carepnt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div name="Patient Instructions" class="section-body" id="section-carepnt"><ul class="side-nav"><li><a href="../patientinstructions/000126.htm">Concussion in adults - discharge</a></li>
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<li><a href="../patientinstructions/000125.htm">Concussion in children - discharge</a></li>
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<li><a href="../patientinstructions/000130.htm">Preventing head injuries in children</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Berger JR, Price R. Stupor and coma. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. <em>Bradley and Daroff's Neurology in Clinical Practice.</em> 8th ed. Philadelphia, PA: Elsevier; 2022:chap 5.</p><p>Lei C, Smith C. Depressed consciousness and coma. In: Walls RM, ed. <em>Rosen's Emergency Medicine: Concepts and Clinical Practice</em>. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 12.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 4/29/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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