An organic confusional state
Much faster course than dementia (which is gradual, over months to years)
Defined as
     A global inability to relate to the environment and process sensory input
NOT defined as
     Alterations in mental status resulting from extreme emotional stimulus (this is a functional abnormality instead)
Sx
     Acute onset of a disturbance in the level of consciousness, cognition and attentiveness (c.f. demential where consciousness is preserved)
     Increased alertness and psychomotor activity     
     May have hallucinations
     Disturbances in consciousness, cognition and perception; which tend to occur over a short period of time (hours to days)
     May be agitated and combative or calm and quiet
     Thought process may be mildly disturbed or glossly disorganized
     May be subdued or explosive and can fluctuate over minutes to hours
     Sleep-wake cycle may be altered or reversed
     Agitation is often present during the night
     Elderly patients with delirium may have low, normal or high temperature
NOT Sx
     Oriented (patients are more likely to have functional causes for altered mental status)
Ddx
     Medications (22-39% of cases in the elderly)
     Infection
     Metabolic abnormality
          Hepatic encephalopathy
          Acute renal failure
          Diabetic ketoacidosis
          Hyperosmolarity
Tx
     Treat underlying cause
     Minimize stimulation because patients with delirium have difficulty processing stimuli

Content on this page has not been checked for accuracy. The author's credentials have not been confirmed. Always use multiple peer-reviewed scholarly sources and good clinical judgement in your decision making.

The Compendium platform was created by David Kwinter, MD, CCFP(EM).

Dr. Kwinter is a Cayman Family Doctor. He runs a Family Medicine Clinic at Cayman Medical in George Town, Grand Cayman, Cayman Islands.