Radiographic and Other Studies

1. Neuroimaging (CT or MRI scan). Perform on all patients with altered mental status. Not needed emergently if patient's exam findings are normal and history indicates only altered arousal. MRI is a more sensitive exam and visualizes posterior fossa better than CT scan; however, MRI requires that patient remain still for a prolonged period of time and therefore often requires sedation.

2. EEG. The gold standard for seizures, because it is the only study that demonstrates cerebral electrical activity (physiologic cause of seizures). In addition, EEG can demonstrate cerebral cortical dysfunction due to a generalized encephalopathy or localized destructive or space-occupying lesion.

3. ECG. Obtain if cardiac disorder is suspected.

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