Confusion and delirium: Difference between revisions
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===Pathophysiology=== | ===Pathophysiology=== | ||
As far as we can ascertain: | As far as we can ascertain: | ||
*If your body is a bit messed up, ie. electrolyte | *If your body is a bit messed up, ie. [[electrolyte disturbance]], [[infection]] etc, you get confused. | ||
*If your brain isn't working properly, ie. alzheimer's disease, etc, you get confused. | *If your brain isn't working properly, ie. [[alzheimer's disease]], etc, you get confused. | ||
*If your brain is getting squashed, ie. massive brain tumour, etc, you get confused. | *If your brain is getting squashed, ie. massive [[brain tumour]] or [[brain abscess]], etc, you get confused. | ||
===Clinical and Associated Features=== | ===Clinical and Associated Features=== | ||
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*[[Sepsis]] | *[[Sepsis]] | ||
*[[Dementia]] | *[[Dementia]] | ||
*[[Electrolyte disturbance]] | |||
*[[Drug and alcohol abuse]] | *[[Drug and alcohol abuse]] | ||
*[[Stroke]] | *[[Stroke]] | ||
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*[[Trauma]] | *[[Trauma]] | ||
*[[Brain cancer]] (either a brain tumour or a brain met) | *[[Brain cancer]] (either a brain tumour or a brain met) | ||
===Investigations=== | ===Investigations=== | ||
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#[[Septic screen]]. | #[[Septic screen]]. | ||
#[[CT scan]] of brain, to check for bleeds or clots. | #[[CT scan]] of brain, to check for bleeds or clots. | ||
Latest revision as of 13:20, 2 January 2010
Definition
Confusion is a loss of orientation (not knowing where, when, who and what you are), often combined with a loss of memory. Delirium is a short term state of confusion, accompanied with altered consciousness.
Epidemiology
Very common, especially in the elderly, or very ill.
Pathophysiology
As far as we can ascertain:
- If your body is a bit messed up, ie. electrolyte disturbance, infection etc, you get confused.
- If your brain isn't working properly, ie. alzheimer's disease, etc, you get confused.
- If your brain is getting squashed, ie. massive brain tumour or brain abscess, etc, you get confused.
Clinical and Associated Features
- Impaired cognitive function
- Hallucination
- Thought disturbances
- Aggression
- Agitation
- Retardation
- Sleep disturbance
- Mood disturbance
Dementia rears its ugly head
It's important to know the difference between dementia and delirium, although Lewy Body dementia can be misleading because it can fluctuate so wildly:
Dementia has a chronic onset. It is usually primary, and has a relatively constant state, worsening over months rather than hours.
Delirium has an acute onset, and is secondary to something else. It often causes sleep disturbance and affects consciousness levels, and fluctuates rapidly, over days rather than months.
Differential Diagnosis
- Sepsis
- Dementia
- Electrolyte disturbance
- Drug and alcohol abuse
- Stroke
- Alcohol withdrawal
- Trauma
- Brain cancer (either a brain tumour or a brain met)
Investigations
- History, to screen for dementia and drug or alcohol abuse.
- Septic screen.
- CT scan of brain, to check for bleeds or clots.