Definition Delirium is caused by many medical conditions and describes the confused state of mind if a person may be unable to maintain attention and whose thinking may be disorganised.
What is going on in the body? Delirium usually develops rapidly and requires immediate evaluation and treatment. The brain is unable to process information in the proper way. Delirium is usually reversible once the cause is identified. A person with delirium is unable to focus attention or reply appropriately to questions. Delirium is more common in the elderly and may uncover previously unrecognised dementia.
What are the signs and symptoms of the condition? A person who is delirious:
cannot stay focused on what is going on around him or her
may have disorganised and defective thinking
may ramble or use unrecognisable speech
may be disoriented as to time, place, or person
may be unable to identify friends or family
may fluctuate in their thinking
The person could have:
memory impairment
a reduced level of consciousness
hallucinations
sleep disturbances
What are the causes and risks of the condition? Delirium can be caused by many things including:
abnormal sodium, chloride, ammonia, or other electrolyte levels in the blood
What can be done to prevent the condition? The best way to prevent delirium is to avoid illegal drugs and overuse of alcohol. It is important to seek proper treatment for all medical conditions. People with diabetes must monitor their blood sugar regularly to prevent abnormally low or high levels. An attempt to eat healthily and stay healthy is important.
How is the condition diagnosed? Delirium requires immediate medical attention. A complete medical history and physical examination is necessary. Laboratory tests include drug and alcohol screening, blood sugar, and electrolytes, among others. A spinal tap or a cranial CT scan is often necessary.
What are the long-term effects of the condition? People with delirium may require a long stay in the hospital and may have a poor outcome.
What are the risks to others? People who are delirious can become very agitated and physically violent. Caregivers may be accidentally injured.
What are the treatments for the condition? Treatment depends on the causes of the delirium. Symptoms can usually be reversed once the underlying cause is identified and treated. This is particularly true if the cause is low blood sugar or hypoglycaemia. People with delirium are most comfortable in a quiet, calm, low-lit environment with familiar surroundings. Restraints may be necessary if the person is highly agitated. Sometimes the agitation must also be treated. In this case the smallest dose of psychoactive medications is used. because the drugs themselves may worsen the confusion while they calm the agitation. Medications are stopped as soon as possible so recovery from delirium can be assessed.
What are the side effects of the treatments? Some psychoactive medications can actually cause confusion, which is a symptom of delirium. Usually, few significant side effects appear from treatment after the cause of delirium is identified.
What happens after treatment for the condition? Recovery from delirium can be slow. The rate of recovery can depend on the cause. Elderly individuals often recover at a slower rate.
How is the condition monitored? The individual is monitored through blood chemistries and through physical examinations. The specific monitoring will differ based on the cause of the delirium.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
