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Causes and diagnosis of unconsciousness 

Causes and diagnosis of unconsciousness
Chapter:
Causes and diagnosis of unconsciousness
Author(s):

Robert D. Stevens

and Joshua Kornbluth

DOI:
10.1093/med/9780199600830.003.0228
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date: 27 November 2020

Changes in consciousness are seen in a range of physiological and pathological settings including sleep, anaesthesia, brain lesions, metabolic disturbances, and complex partial or generalized seizures. In neurobiological terms, consciousness may be viewed as having an arousal dimension and an awareness dimension phenotypically expressed as the capacity to respond to self or environmental stimuli. Loss of consciousness is associated with lesions that disrupt neuronal systems in the brainstem and diencephalon that mediate arousal or thalamocortical or corticocortical systems that mediate awareness. As there are many causes of unconsciousness, a timely and focused history and neurologic examination are critical to defining the differential diagnosis.

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