Acute Confusion: High altitude

Cerebral oedema. In high mountainous areas one should watch out for acute cerebral oedema due to altitude sickness in cases of acute confusion, Cheyne-Stokes respiration, ataxia, disorientation or other neurological problems. Fast administration of oxygen and dexamethasone and immediate evacuation to an area at lower altitude with medical infrastructure is imperative. Acetazolamide (Diamox®) can be used prophylactically with limited efficacy.

It should of course be borne in mind that an already existing cardiovascular disease can worsen the relative hypoxia at high altitude.

A poorly burning stove in an unventilated environment can cause carbon monoxide poisoning (CO-intoxication).

Mefloquine taken for malaria prevention in low-lying areas and continued to be taken in the mountains can result in confusion. The same warning applies for alcohol.

Category: Neurology notes , Physiology Notes