Altered Mental Status

I have had altered mental status for 2 years more frequently since quad bypass surgery in Dec 2008. There is no head trauma but  I am diabetic and have neuropathic degeneration (Guillian Barre syndrome?) that causes constant pain. I am on multiple meds for diabetes, heart and nerve pain. Is the nerve damage causing the AMS or is my brain shutting down because of the extreme pain?  Nothing shows on CAT scan or blood work ( not tested for Lyme disease yet).  The AMS started after my first surgery in 2006  for nerve pain on my left shoulder.  Could the anesthesia have cause a malfunction in my brain?  Is there a treatment?

[DrNoopurMD]

Hi,

How are you?
There are five major causes of AMS. From most common to least common is drug toxicity or overdose, metabolic derangements like electrolyte imbalance, uremia, and diabetic ketoacidosis, structural lesions like brain tumors, intracranial hemorrhage, and hydrocephalus and lastly psychiatric illnesses like schizophrenia.
Guillian barre syndrome affects the peripheral nervous system so it cannot be the cause of AMS.
Is your diabetes under control? What all medications are you currently on?
Certain medications can damage the liver and cause AMS. Please elaborate.
The treatment would depend on the cause so the underlying cause needs to be identified first.