Level of Arousal
November 7th, 2019
Overview
The patient's level of arousal is an assessment of how awake and active they are. Patients may be hyperactive or display psychomotor agitation, or conversely show evidence of psychomotor retardation or even stupor.
Hyperactivity
Hyperactivity refers to an increase in purposeful, goal-oriented activity. Examples might include excessive cleaning or excessive talking.
Significance
- May be related to anxiety or mania.
Psychomotor Agitation
Pshcomotor agitation refers to purposeless, goal-less activity that the patient may be displaying; these
Look For
- Fidgeting
- Wringing hands
- Shifting position
- Inability to remain seated
- Pacing
Causes of Psychomotor Agitation
- Anxiety disorders
- Mood disorders - depression, bipolar affective disorder
- Schizophrenia
- Drug intoxication / withdrawal
- Delirium
- Dementia
Psychomotor Retardation
Look For
- Reduced movement, speech and thinking.
Causes of Psychomotor Retardation
- Depression
- Frontal lobe pathology
- Dementias
- Hypothyroidism
Stupor
A stupor is a state that lies somewhere between full awareness and coma.
Signs of Stupor
- Mutism
- Immobility
- Unresponsiveness to stimuli
- Disturbances in eating, drinking, defaecating and passing urine
- Catalepsy: maintenance of an awkward posture or position
Causes of Stupor
- Catatonia - depression, schizophrenia, stroke
- Depressive stupor
- Organic pathology - cerebral or brainstem lesions
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