Could Paula and the patients described in Manic Depressive Insanity have a potentially reversible metabolic encephalopathy? Yes! That is why vital signs, and especially respiratory rate is such a useful thing to measure. Respiratory rate is the only way to judge the state of the motor system involved in the mechanical motor act of breathing. Depth of breathing will tell you about the health of the lungs. Breathing air takes both the healthy lungs and the healthy muscles of the torso, etc…to move the air in and out, which is dependent on the air pressure of the atmosphere and the air pressure within the lungs and the ability of the respiratory muscles to adjust and pivot when needed. Given the discovery of abnormal stable patterns of vital signs and the reported problems with *minute ventilation, [a general medical evaluation of the motor behaviour and the mechanical capacity of the body to move air and to pivot respiratory rate easily in order to manage homeostasis effectively]
* Minute ventilation; see past blog posts
To be continued……………
Patients with metabolic encephalopathy may present in several ways depending on the magnitude and temporal course of the abnormality, the individual’s age and neuronal reserve (i.e., the capacity to compensate for dysfunction). Ironically, patients with many causes of encephalopathy can look very similar, and it is usually not possible to determine the cause based on symptoms alone. from Reeves; Disorders of the nervous system ALTERED MENTAL STATUS
What is metabolic encephalopathy?
Metabolic encephalopathy is a problem in the brain. It is caused by a chemical imbalance in the blood. The imbalance is caused by an illness or organs that are not working as well as they should. It is not caused by a head injury. When the imbalance affects the brain, it can lead to personality changes. It can also make it harder to think clearly and remember things.
The problems may only last a short time if you get treatment right away. But this depends on the cause. If the imbalance has been building up because you’ve been sick for a long time, the mental changes may be more severe. They may also last longer.
What happens when you have this problem?
When things are working right, your body has many ways to keep the chemicals in your blood in balance. For example, your liver and kidneys remove waste from your blood. The kidneys also help keep fluids and sodium in balance. And your pancreas makes insulin. It is a hormone that helps control the amount of sugar in your blood.
But the chemicals in your blood can get out of balance and damage parts of your body because of a medical problem. This may be kidney or liver failure. Or it could be diabetes that isn’t controlled well. When the imbalance affects the brain, normal thinking and behaviour can change.
What are the symptoms?
Symptoms may include:
- Problems with thinking and remembering.
- Being grouchy and depressed.
- Feeling drowsy.
- Not being able to sleep.
- Passing out (fainting) now and then.
How is it treated?
The doctor will try to find the illness that’s causing the problem. He or she may ask questions about your past health.
The doctor will also do tests to find what is causing the chemical imbalance and to see how severe it is.
The doctor may treat the organ system that’s causing the problem. For example, if it’s a kidney problem, you may have treatment to help your kidneys work better. If you have an infection, you may need antibiotics. If the doctor can’t treat the cause of the problem, he or she will treat the symptoms.
The doctor will carefully watch your blood chemicals to make sure that your treatment is being done safely.
Follow-up care is a key part of your treatment and safety.Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.For 24/7 nurse advice and general health information call Health Link at 811.
Current as of: August 12, 2019 https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abo4850 Author: Healthwise Staff Medical Review: Adam Husney MD – Family Medicine