MOVE STUPID for altered mental status

The following Mnemonic can be used to remember many of the common differential diagnoses that cause altered mental status. 

M   Metabolic causes such as high/low sodium or hepatic encephalopathy. 

                       Testing: Electrolyte panel and ammonia level 

O   Oxygen or carbon dioxide (Low O2 or high CO2)  

                       Testing:  arterial blood gas or pulse ox for O2 

V   Vascular abnormality such as stroke or intracranial hemorrhage 

                       Testing: CT/CTA/MRI 

E   Endocrine abnormality such as hypoglycemia or hypo/hyperthyroid 

                       Testing: Blood glucose, Thyroid Stimulating Hormone, T3, T4

S   Seizure 

                       Testing: EEG

T   Tumor or Temperature (hypothermia) or Thiamine

                       Testing: MRI Brain with contrast, thermometer 

U   Uremia

                       Testing: BUN 

P    Psych (Hypo/Hyperactive delirium, Mental Illness, Dementia) 

                       Testing: Psych consult or diagnosis of exclusion 

I     Infection, ICP elevation, Inflammation (Encephalitis): meningitis, sepsis, cerebral edema,      hydrocephalus 

                        Testing: Lumbar puncture, urine culture, blood culture, sputum culture, head CT

D   Drugs and Alcohol. This can include too much or too little (withdrawal) 

                        Testing: HPI with drug/alcohol abuse, drug screen, alcohol level