What is the role of lab testing in the workup of delirium, dementia, and amnesia?

Updated: Sep 19, 2018
  • Author: Richard D Shin, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Answer

Laboratory studies may be helpful for ruling in or excluding specific diagnoses that cause delirium or a dementia-like presentation. Many of these tests may not be immediately available to the ED physician including vitamin levels, Venereal Disease Research Laboratory (VDRL) test, and certain thyroid function studies.

Oxygen saturation, or ABG with carbon monoxide level, may be diagnostic. CBC, electrolytes, blood glucose, BUN and creatinine should be checked. In older patients, consider vitamin B-12 and folate levels. Consider calcium level, magnesium level, liver function tests (LFTs), serum ammonia, and prothrombin time (PT). Consider VDRL and/or fluorescent treponemal antibody absorption (FTA-ABS) test to help rule out neurosyphilis (see cerebrospinal fluid [CSF] studies below). Urinalysis is also indicated.


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