Thank you Dr. Kristina Lee for a great morning report on a patient with a history of lupus who developed acute mental status change during hospitalization found to have communicating hydrocephalus

Learning Points:

• The overwhelming majority of causes for AMS are metabolic, toxic, and infectious
• The differential diagnosis for the neuropsychiatric manifestations of lupus is broad and includes central and peripheral processes
• For your patients on prophylactic lovenox requiring a lumbar puncture, hold the dose for 24 hours prior to procedure to avoid an epidural hematoma which can be catestrophic