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The diagnosis of hepatic encephalopathy is a clinical one, once other causes for confusion or coma have been excluded; no test fully diagnoses or excludes it. Serum ammonia levels are elevated in 90% of people, but not all hyperammonaemia (high ammonia levels in the blood) is associated with encephalopathy.
Ketamine is an option in children as the sole anesthetic for minor procedures or as an induction agent followed by neuromuscular blocker and tracheal intubation. [42] In particular, children with cyanotic heart disease and neuromuscular disorders are good candidates for ketamine anesthesia.
Susceptible individuals may respond to benzodiazepine treatment with an increase in anxiety, aggressiveness, agitation, confusion, disinhibition, loss of impulse control, talkativeness, violent behavior, and even convulsions. Paradoxical adverse effects may even lead to criminal behavior. [13]
Substance avoidance can be important in reducing anxiety and panic symptoms, as many substances can cause, exacerbate, or mimic symptoms of panic disorder. For example, caffeine has been known to have anxiety and panic-inducing properties that can especially present in those who are more susceptible to panic attacks. [ 60 ]
“Children and adults who inadvertently consume a higher dose of clonazepam could be at increased risk for the adverse events of significant sedation, confusion, dizziness, diminished reflexes ...
In children, confusional arousals can often be reproduced artificially by awakening the child during deep sleep. [3] However, it doesn't have any clinical significance without deeper investigation. Children living an episode of confusional arousal typically sit up in bed, whimper, cry, moan, and may utter words like “no” or “go away”.
Delirium (formerly acute confusional state, an ambiguous term which is now discouraged) [1] is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days.
Children may exhibit behavioral symptoms such as over-activity, disobedience to parental or caretaker's instructions. New habits or habits of regression may appear, such as thumb-sucking, wetting the bed and teeth grinding. Children may exhibit changes in eating habits or other habits such as biting nails or picking at skin due to stress. [28]
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