Delirium Causes, Symptoms, Diagnosis and Treatment

What is Delirium?

Delirium is a serious disturbance in mental abilities that results in confused thinking and reduced awareness of your environment.

It is typified by fluctuating course, attention deficits and generalized severe disorganization of behavior. It is not a disease but a clinical syndrome.

Causes Of Delirium:

Delirium is most often caused by physical or mental illness, and is usually temporary and reversible. Some of the causes include:

Alcohol or sedative drug withdrawal
Drug abuse
Body chemical disturbances
Infections such as urinary tract infections or pneumonia (more likely in people who already have brain damage from stroke or dementia)
Poisons
Surgery
Malnutrition or dehydration
Sleep deprivation or severe emotional distress

Several medications or combinations of drugs can trigger delirium, including some types of:

Pain drugs
Sleep medications
Medications for mood disorders, such as anxiety and depression
Allergy medications (antihistamines)
Parkinson’s disease drugs
Drugs for treating spasms or convulsions
Asthma medications

Symptoms Of Delirium:

Some of the symptoms of delirium may include the following:

Changes in alertness (usually more alert in the morning, less alert at night)
Changes in feeling (sensation) and perception
Changes in level of consciousness or awareness
Changes in movement (for example, may be slow moving or hyperactive)
Changes in sleep patterns, drowsiness
Confusion (disorientation) about time or place
Decrease in short-term memory and recall
Disorganized thinking, such as talking in a way that doesn’t make sense
Emotional or personality changes, such as anger, agitation, depression, irritability, overly happy
Incontinence
Movements triggered by changes in the nervous system
Problem concentrating

Diagnosis Of Delirium:

The following tests and exams are conducted in order to diagnose delirium:

An exam of the nervous system (neurologic examination), including tests of feeling (sensation), thinking (cognitive function), and motor function
Neuropsychological studies
Blood and urine tests
Chest x-ray
Cerebrospinal fluid (CSF) analysis (spinal tap)
Electroencephalogram (EEG)
Head CT scan
Head MRI scan
Mental status test

Treatment Of Delirium:

Treatment for delirium can be broadly categorized into supportive care and medications.

Supportive care

Supportive care aims to prevent complications by:

1. Protecting the airway
2. Providing fluids and nutrition
3. Assisting with movement
4. Treating pain
5. Addressing incontinence
6. Avoiding use of physical restraints and bladder tubes
7. Avoiding changes in surroundings and caregivers when possible
8. Encouraging the involvement of family members or familiar people

Medications
Certain medications may be needed to control pain that’s causing delirium.

Other types of drugs may help calm a person who misinterprets the environment in a way that leads to severe paranoia, fear or hallucinations, and when severe agitation or confusion occurs. These drugs may be needed when certain behaviors: