BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuDeliriumAcute confusional state; Acute brain syndromeDelirium is sudden severe confusion due to rapid changes in brain function that occur with physical or mental illness.ConfusionConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article Causes Delirium is most often caused by physical or mental illness and is usually temporary and reversible. Many disorders cause delirium. Often, these do not allow the brain to get oxygen or other substances. They may also cause dangerous chemicals (toxins) to build up in the brain. Delirium is common in the intensive care unit (ICU), especially in older adults.Causes include:Alcohol or medicine overdose or withdrawal Drug use or overdose, including being sedated in the ICU Electrolyte or other body chemical disturbances ElectrolyteElectrolytes are minerals in your blood and other body fluids that carry an electric charge. Electrolytes affect how your body functions in many ways...Read Article Now Book Mark Article Infections such as urinary tract infections or pneumonia Urinary tract infectionsA urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in the urinary tract, including...ImageRead Article Now Book Mark Article PneumoniaPneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...ImageRead Article Now Book Mark Article Severe lack of sleep Poisons General anesthesia and surgery Symptoms Delirium involves a quick change between mental states (for example, from lethargy to agitation and back to lethargy).LethargyFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article AgitationAgitation is an unpleasant state of extreme arousal. An agitated person may feel stirred up, excited, tense, confused, or irritable.Read Article Now Book Mark Article Symptoms include: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 level of consciousnessDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article Changes in movement (for example, may be slow moving or hyperactive) Changes in sleep patterns, drowsiness DrowsinessDrowsiness refers to feeling more sleepy than normal during the day. People who are drowsy may fall asleep when they do not want to or at times whic...Read Article Now Book Mark Article 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, and overly happy Incontinence IncontinenceUrinary (or bladder) incontinence occurs when you are not able to keep urine from leaking out of your urethra. The urethra is the tube that carries ...ImageRead Article Now Book Mark Article Movements triggered by changes in the nervous system Problem concentrating Exams and Tests The following tests may have abnormal results:An examination of the nervous system (neurologic examination), including tests of feeling (sensation), mental status, thinking (cognitive function), and motor function Neuropsychological studies The following tests may also be done:Blood and urine tests Chest x-ray Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article Cerebrospinal fluid (CSF) analysis (spinal tap, or lumbar puncture) Cerebrospinal fluid (CSF) analysisA CSF cell count is a test to measure the number of red and white blood cells that are in cerebrospinal fluid (CSF). CSF is a clear fluid that is in...ImageRead Article Now Book Mark Article Electroencephalogram (EEG) ElectroencephalogramAn electroencephalogram (EEG) is a test to measure the electrical activity of the brain.ImageRead Article Now Book Mark Article Head CT scan Head CT scanA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.ImageRead Article Now Book Mark Article Head MRI scan Head MRI scanA head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...ImageRead Article Now Book Mark Article Mental status test Treatment The goal of treatment is to control or reverse the cause of the symptoms. Treatment depends on the condition causing delirium. The person may need to stay in the hospital for a short time.Stopping or changing medicines that worsen confusion, or that are not necessary, may improve mental function. Disorders that contribute to confusion should be treated. These may include:Anemia AnemiaAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...ImageRead Article Now Book Mark Article Decreased oxygen (hypoxia) HypoxiaA bluish color to the skin or mucous membrane is usually due to a lack of oxygen in the blood. The medical term is cyanosis.ImageRead Article Now Book Mark Article Heart failure Heart failureHeart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...ImageRead Article Now Book Mark Article High carbon dioxide levels (hypercapnia) HypercapniaCO2 is carbon dioxide. This article discusses the laboratory test to measure the amount of carbon dioxide in the liquid part of your blood, called t...ImageRead Article Now Book Mark Article Infections Kidney failure Kidney failureAcute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...ImageRead Article Now Book Mark Article Liver failure Nutritional disorders Psychiatric conditions (such as depression or psychosis) Thyroid disorders Treating medical and mental disorders often greatly improves mental function.Medicines may be needed to control aggressive or agitated behaviors. These are usually started at very low dosages and adjusted as needed.Some people with delirium may benefit from hearing aids, glasses, or cataract surgery.Cataract surgeryCataract removal is surgery to remove a clouded lens (cataract) from the eye. Cataracts are removed to help you see better. The procedure almost al...ImageRead Article Now Book Mark Article Other treatments that may be helpful:Behavior modification to control unacceptable or dangerous behaviors Reality orientation to reduce disorientationOrientationMental status testing is done to check a person's thinking ability and to determine if any problems are getting better or worse. It is also called n...Read Article Now Book Mark Article DisorientationConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article Outlook (Prognosis) Acute conditions that cause delirium may occur with long-term (chronic) disorders that cause dementia. Acute brain syndromes may be reversible by treating the cause.ChronicChronic refers to something that continues over an extended period of time. A chronic condition is usually long-lasting and does not easily or quick...ImageRead Article Now Book Mark Article DementiaDementia is a loss of brain function that occurs with certain diseases. It affects one or more brain functions such as memory, thinking, language, j...ImageRead Article Now Book Mark Article Delirium often lasts about 1 week. It may take several weeks for mental function to return to normal. Full recovery is common, but depends on the underlying cause of the delirium. Possible Complications Problems that may result from delirium include:Loss of ability to function or care for self Loss of ability to interact Progression to stupor or coma StuporDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article ComaDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article Side effects of medicines used to treat the disorder When to Contact a Medical Professional Contact your health care provider if there is a rapid change in mental status.Change in mental statusConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article Prevention Treating the conditions that cause delirium can reduce its risk. In hospitalized people, avoiding or using a low dosage of sedatives, prompt treatment of metabolic disorders and infections, and using reality orientation programs will reduce the risk of delirium in those at high risk.Open ReferencesReferencesGuthrie PF, Rayborn S, Butcher HK. Evidence-based practice guideline: delirium. J Gerontol Nurs. 2018;44(2):14-24. PMID: 29378075 www.ncbi.nlm.nih.gov/pubmed/29378075/.Inouye SK. Delirium in the older patient. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 25.Mendez MF, Yerstein O. Delirium. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley's and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 4.AllVideoImagesTogCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.Central nervous system and peripheral nervous systemillustrationBrain - illustration The major areas of the brain have one or more specific functions.BrainillustrationCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.Central nervous system and peripheral nervous systemillustrationBrain - illustration The major areas of the brain have one or more specific functions.BrainillustrationRelated Information Confusion(Symptoms)Acute(Special Topic)Electrolytes(Special Topic)Decreased alertness(Symptoms) Review Date: 11/9/2021 Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
DeliriumAcute confusional state; Acute brain syndromeDelirium is sudden severe confusion due to rapid changes in brain function that occur with physical or mental illness.ConfusionConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article Causes Delirium is most often caused by physical or mental illness and is usually temporary and reversible. Many disorders cause delirium. Often, these do not allow the brain to get oxygen or other substances. They may also cause dangerous chemicals (toxins) to build up in the brain. Delirium is common in the intensive care unit (ICU), especially in older adults.Causes include:Alcohol or medicine overdose or withdrawal Drug use or overdose, including being sedated in the ICU Electrolyte or other body chemical disturbances ElectrolyteElectrolytes are minerals in your blood and other body fluids that carry an electric charge. Electrolytes affect how your body functions in many ways...Read Article Now Book Mark Article Infections such as urinary tract infections or pneumonia Urinary tract infectionsA urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in the urinary tract, including...ImageRead Article Now Book Mark Article PneumoniaPneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...ImageRead Article Now Book Mark Article Severe lack of sleep Poisons General anesthesia and surgery Symptoms Delirium involves a quick change between mental states (for example, from lethargy to agitation and back to lethargy).LethargyFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article AgitationAgitation is an unpleasant state of extreme arousal. An agitated person may feel stirred up, excited, tense, confused, or irritable.Read Article Now Book Mark Article Symptoms include: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 level of consciousnessDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article Changes in movement (for example, may be slow moving or hyperactive) Changes in sleep patterns, drowsiness DrowsinessDrowsiness refers to feeling more sleepy than normal during the day. People who are drowsy may fall asleep when they do not want to or at times whic...Read Article Now Book Mark Article 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, and overly happy Incontinence IncontinenceUrinary (or bladder) incontinence occurs when you are not able to keep urine from leaking out of your urethra. The urethra is the tube that carries ...ImageRead Article Now Book Mark Article Movements triggered by changes in the nervous system Problem concentrating Exams and Tests The following tests may have abnormal results:An examination of the nervous system (neurologic examination), including tests of feeling (sensation), mental status, thinking (cognitive function), and motor function Neuropsychological studies The following tests may also be done:Blood and urine tests Chest x-ray Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article Cerebrospinal fluid (CSF) analysis (spinal tap, or lumbar puncture) Cerebrospinal fluid (CSF) analysisA CSF cell count is a test to measure the number of red and white blood cells that are in cerebrospinal fluid (CSF). CSF is a clear fluid that is in...ImageRead Article Now Book Mark Article Electroencephalogram (EEG) ElectroencephalogramAn electroencephalogram (EEG) is a test to measure the electrical activity of the brain.ImageRead Article Now Book Mark Article Head CT scan Head CT scanA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.ImageRead Article Now Book Mark Article Head MRI scan Head MRI scanA head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...ImageRead Article Now Book Mark Article Mental status test Treatment The goal of treatment is to control or reverse the cause of the symptoms. Treatment depends on the condition causing delirium. The person may need to stay in the hospital for a short time.Stopping or changing medicines that worsen confusion, or that are not necessary, may improve mental function. Disorders that contribute to confusion should be treated. These may include:Anemia AnemiaAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...ImageRead Article Now Book Mark Article Decreased oxygen (hypoxia) HypoxiaA bluish color to the skin or mucous membrane is usually due to a lack of oxygen in the blood. The medical term is cyanosis.ImageRead Article Now Book Mark Article Heart failure Heart failureHeart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...ImageRead Article Now Book Mark Article High carbon dioxide levels (hypercapnia) HypercapniaCO2 is carbon dioxide. This article discusses the laboratory test to measure the amount of carbon dioxide in the liquid part of your blood, called t...ImageRead Article Now Book Mark Article Infections Kidney failure Kidney failureAcute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...ImageRead Article Now Book Mark Article Liver failure Nutritional disorders Psychiatric conditions (such as depression or psychosis) Thyroid disorders Treating medical and mental disorders often greatly improves mental function.Medicines may be needed to control aggressive or agitated behaviors. These are usually started at very low dosages and adjusted as needed.Some people with delirium may benefit from hearing aids, glasses, or cataract surgery.Cataract surgeryCataract removal is surgery to remove a clouded lens (cataract) from the eye. Cataracts are removed to help you see better. The procedure almost al...ImageRead Article Now Book Mark Article Other treatments that may be helpful:Behavior modification to control unacceptable or dangerous behaviors Reality orientation to reduce disorientationOrientationMental status testing is done to check a person's thinking ability and to determine if any problems are getting better or worse. It is also called n...Read Article Now Book Mark Article DisorientationConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article Outlook (Prognosis) Acute conditions that cause delirium may occur with long-term (chronic) disorders that cause dementia. Acute brain syndromes may be reversible by treating the cause.ChronicChronic refers to something that continues over an extended period of time. A chronic condition is usually long-lasting and does not easily or quick...ImageRead Article Now Book Mark Article DementiaDementia is a loss of brain function that occurs with certain diseases. It affects one or more brain functions such as memory, thinking, language, j...ImageRead Article Now Book Mark Article Delirium often lasts about 1 week. It may take several weeks for mental function to return to normal. Full recovery is common, but depends on the underlying cause of the delirium. Possible Complications Problems that may result from delirium include:Loss of ability to function or care for self Loss of ability to interact Progression to stupor or coma StuporDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article ComaDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article Side effects of medicines used to treat the disorder When to Contact a Medical Professional Contact your health care provider if there is a rapid change in mental status.Change in mental statusConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article Prevention Treating the conditions that cause delirium can reduce its risk. In hospitalized people, avoiding or using a low dosage of sedatives, prompt treatment of metabolic disorders and infections, and using reality orientation programs will reduce the risk of delirium in those at high risk.Open ReferencesReferencesGuthrie PF, Rayborn S, Butcher HK. Evidence-based practice guideline: delirium. J Gerontol Nurs. 2018;44(2):14-24. PMID: 29378075 www.ncbi.nlm.nih.gov/pubmed/29378075/.Inouye SK. Delirium in the older patient. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 25.Mendez MF, Yerstein O. Delirium. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley's and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 4.