stupor

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It is a state of lethargy with altered consciousness and immobility.
If we found someone in stuporous condition,it may be due to neurological causes(meningitis,intra or extra cranial bleeding,tumour)or metabolic causes(hypoglycemia,electrolyte imbalance,hypocalcemia,hypomagnesemia).It can occur due to psychiatric conditions(schizophrenia,mood disorder,PTSD,alcohol dependence,other drug abuse such as opioid) and its called catatonic stupor.Some of the antiepileptic medication(phenytoin),overdosage of antipsychotic,sudden withdrawal of benzodiazepin(diazepam,nitarzepam) can also induce stuporous state.
Various encephalopathies( conditions in which the functioning of the brain is affected by some agent or abnormalities)such as hepatic encephalopathy,renal encephalopathy ,encephalopathy due to poisoning,infections can also cause stupor and coma.
Breath odor is one of the sign to detect possible cause.In a stuporous patient with organophosphorous(various pesticides) poisoining,there will be a garlicky smell in the breath.It will be fruity sweet smell in diabetic ketoacidosis,fishy odor suggest hepatic encephalopathy,dirty rest room smell in renal encephalopathy and in substance abuse,depending upon the substance,there will be corresponding breath odor.(eg.very strong acrid/sweet/metallic/pungent odor in opioid users,smell of alcohol in alcoholics).As there is different odor in breath as well as in body of a stuporous or comatose patient,a sniff dog can be a better doctor to detect the cause of stupor or coma!.

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