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Updated: Feb 1, 2026

Ammonia Synthesis at Low Pressure
Published on: August 23, 2017
A 33-Year-Old Woman With Altered Mental Status and Elevated Ammonia Level
Alessandra Morello Gearhart1, John J Guardiola2, Karim El-Kersh1
1Department of Medicine, Division of Pulmonary Critical Care and Sleep Disorders Medicine, University of Louisville, Louisville, KY.
Case Presentation:
A 33-year-old woman was brought to the ED with altered mental status. She was combative on presentation but spontaneously progressed into a comatose state and was intubated for airway protection. Naloxone failed to improve her mental status. When family was reached, they reported a history of seizures that were controlled on treatment.
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