Delirium, Information On Delirium, Symptoms Of Delirium, Diagnosis Of Delirium, Treatment Of Delirium

INFORMATION ON DELIRIUM

Delirium is a transient global disorder of cognition. Delirium is a condition of severe confusion and rapid changes in brain function that develops quickly (over hours or days) and involves changes in consciousness, attention, cognition (thinking and reasoning), perception, psychomotor behavior, emotion, and the sleep-wake cycle. Delirium represents a sudden and significant decline from the previous level of functioning. Delirium is usually temporary and reversible and does not reflect a persistent psychiatric disorder. The condition is a medical emergency associated with increased morbidity and mortality rates. The clinical key identifying features are decreased attention span and a waxing and waning type of confusion.
It may occur at any age but is most common after the age of 60 years. The delirious state is transient and of fluctuating intensity; most cases recover within 4 weeks or less. However, delirium may last up to 6 months with fluctuations especially when arising in the course of chronic liver disease, carcinoma, or subacute bacterial endocarditis. A delirious state may progress into dementia. Full recovery is common.

SYMPTOMS OF DELIRIUM

DIAGNOSIS OF DELIRIUM

The various clinical procedures available for diagnosis of delirium are:-

1. CT scan.
2. Chest X-ray.
3. Urine test.
4. EMG.
5. ECG.

TREATMENT FOR DELIRIUM

The main aim of treatment is to control or reverse the cause of the symptoms, and will vary with the specific condition causing delirium. The person should be in a pleasant, comfortable, non-threatening, physically safe environment for diagnosis and initial care. Hospitalization may be required for a short time.

Medications that may worsen confusion include anticholinergics, analgesics, cimetidine, central nervous system depressants, lidocaine, and other medications (including alcohol and illegal drugs).
Disorders that contribute to confusion should be treated. These may include heart failure, decreased oxygen (hypoxia), excessive carbon dioxide levels (hypercapnia), thyroid disorders, anaemia, nutritional disorders, infections, kidney failure, liver failure, and psychiatric conditions (such as depression). Correction of co-existing medical and psychiatric disorders often greatly improves mental functioning. Medications may be required to control aggressive or agitated behaviors or behaviors that are dangerous to the person or to others. These are usually given in very low doses, with adjustment as required.

Medications that may be considered for use include:
-thiamine
-sedating medications such as clonazepam or diazepam
-serotonin-affecting drugs (trazodone, buspirone)
-dopamine blockers (such as haloperidol, olanzapine, Risperdal, clozapine)
-fluoxetine, imipramine, Celexa (may help stabilize mood)