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Fifteen-minute consultation: Approach to the child with an acute confusional state
  1. Manish Prasad1,
  2. Arnab Seal2,
  3. Santosh R Mordekar3
  1. 1Paediatric Neurology Department, Queen's Medical Centre, Nottingham, UK
  2. 2Children's Services, Wortley Beck Health Centre, Leeds Community Healthcare NHS Trust, Leeds, UK
  3. 3Paediatric Neurology Department, Sheffield Children's NHS Foundation Trust, Ryegate Children's Centre, Sheffield, UK
  1. Correspondence to Dr Manish Prasad, Queens Medical Centre, Derby road, Nottingham MG7 2UH, UK; m.prasad{at}


Acute confusional state (ACS) refers to sudden impairment of cognitive function and represents a major medical emergency. The impairment may be global or confined specifically to a particular faculty of higher mental function, such as memory. This review highlights the importance of relevant medical history and clinical signs and symptoms in reaching the correct diagnosis. In this review, we have presented a diagnostic approach to a child presenting with ACS and described commonly encountered causes, their treatments and outcomes. We have also presented an algorithm for the diagnostic approach to the child with ACS.

  • Accident & Emergency
  • confusional state
  • migraine
  • epilepsy

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  • Contributors MP, SM and AS contributed equally towards this article.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.