Delirium can be caused by many medical conditions. It describes the confused state of mind in a person. With delirium, the person may be unable to maintain attention, and thinking may be disorganized. The brain is unable to process information in the proper way.
A person with delirium is unable to focus attention or reply correctly to questions. Delirium usually comes on quickly and needs to be assessed and treated right away. It can usually be turned around once the cause is known. Delirium is more common in older people and may uncover dementia that wasn't noticed before.
Delirium can be caused by many things including:
A person who is delirious:
The person could have:
Delirium requires immediate medical attention. A complete medical history and physical exam is necessary. Lab tests include drug and alcohol screening, blood glucose, and electrolytes, among others. A spinal tap or a cranial CT scan is often needed.
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 glucose often to prevent very low or high levels. An attempt to eat healthy and stay healthy is important.
People with delirium may require a long stay in the hospital. If the cause cannot be established or treated, they may have a poor outcome.
People who are delirious can become very upset and even violent. Caregivers may be injured by accident.
Treatment depends on the cause of the delirium. Symptoms can usually be reversed once the actual cause is named and treated. This is particularly true if the cause is low blood sugar or hypoglycemia. People with delirium are most comfortable in an environment that is:
Restraints may be necessary if the person is highly agitated. Sometimes the agitation must also be treated with medicine. In this case, the smallest dose of medicine is used because the drugs themselves may worsen the confusion at the same time that they calm the agitation. Medicines are stopped as soon as possible so recovery from delirium can be assessed.
Some psychoactive medicines can actually cause confusion, which is a symptom of delirium. Usually, few major side effects appear from treatment after the cause of delirium is identified.
Recovery from delirium can be slow. The rate of recovery can depend on the cause. Elderly people often recover at a slower rate.
The individual is monitored through blood chemistry studies and through physical exams. The specific monitoring will differ based on the cause of the delirium.
Author:Terry Mason, MPH
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:06/13/02
Reviewer:Vincent J. Toups, MD
Date Reviewed:05/07/01
Merck Manual, Whitehouse Station, New Jersey, 1995-2000
On-line medical dictionary, 2000
Mayo Clinic, Geriatric Medicine, Topics in Geriatrics, Mayo Foundation for Medical Education and Research, 1996-2000
Taber's Cyclopedic Medical Dictionary, F.A. Davis Company, Philidelphia, PA