Which of the following is a symptom of severe alkalosis?

Severe alkalosis can lead to a range of neurological symptoms due to its effects on the central nervous system. One prominent symptom is confusion, which arises because alkalosis can disrupt the normal functioning of neuronal excitability. The primary impact of increased blood pH levels is the alteration of the ionized calcium levels, leading to hypocalcemia, which can enhance neural excitability and result in neurological manifestations such as confusion, disorientation, and even seizures in extreme cases.

Other symptoms associated with physiological changes during severe alkalosis can include muscle twitching and cramping, but confusion is a clear and notable symptom indicative of the condition's effect on brain function. This connection makes confusion the correct answer when identifying a symptom of severe alkalosis.