Confusion
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembering, and making decisions.
Considerations
Confusion may come on quickly or slowly over time, depending on the cause. Many times, confusion lasts for a short time and goes away. Other times, it is permanent and not curable. It may be associated with delirium or dementia.
Confusion is more common in older people and often occurs during a hospital stay.
Some confused people may have strange or unusual behavior or may act aggressively.
Causes
Confusion may be caused by different health problems, such as:
- Alcohol or drug intoxication
Alcohol
Alcohol use disorder is when your drinking causes serious problems in your life, yet you keep drinking. You may also need more and more alcohol to f...
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Brain tumor
A primary brain tumor is a group (mass) of abnormal cells that start in the brain.
Read Article Now Book Mark Article - Head trauma or head injury (concussion)
Head trauma
A head injury is any trauma to the scalp, skull, or brain. Head injury can be either closed or open (penetrating). A closed head injury means you rec...
Read Article Now Book Mark ArticleHead injury
A head injury is any trauma to the scalp, skull, or brain. Head injury can be either closed or open (penetrating). A closed head injury means you rec...
Read Article Now Book Mark ArticleConcussion
A traumatic brain injury (TBI) can occur when the head hits an object, or a moving object strikes the head. There are three types of TBI:Mild TBI, a...
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- Fluid and electrolyte imbalance
Fluid and electrolyte imbalance
Every part of your body needs water to function. When you are healthy, your body is able to balance the amount of water that enters or leaves your b...
Read Article Now Book Mark Article - Illness in an older person, such as loss of brain function (dementia)
Dementia
Dementia is a loss of brain function that occurs with certain diseases. It affects one or more brain functions such as memory, thinking, language, j...
Read Article Now Book Mark Article - Illness in a person with existing neurological disease, such as a stroke
- Infections
- Lack of sleep (sleep deprivation)
- Low blood sugar
Low blood sugar
Low blood sugar is a condition that occurs when the body's blood sugar (glucose) decreases and is too low. Blood sugar below 70 mg/dL (3. 9 mmol/L) i...
Read Article Now Book Mark Article - Low levels of oxygen (for example, from chronic lung disorders)
- Medicines
- Nutritional deficiencies, especially niacin, thiamine, or vitamin B12
Niacin
Niacin is a type of B vitamin. It is a water-soluble vitamin. It is not stored in the body. Water-soluble vitamins dissolve in water. Leftover am...
Read Article Now Book Mark ArticleThiamine
Beriberi is a disease in which the body does not have enough thiamine (vitamin B1).
Read Article Now Book Mark ArticleVitamin B12
Vitamin B12 is a water-soluble vitamin. Water-soluble vitamins dissolve in water. After the body uses what it needs of these vitamins, leftover amo...
Read Article Now Book Mark Article - Seizures
Seizures
A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...
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Hypothermia
Hypothermia is dangerously low body temperature, below 95°F (35°C).
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Home Care
A good way to find out if someone is confused is to ask the person his or her name, age, and the date. If they are unsure or answer incorrectly, they are confused.
If the person does not usually have confusion, contact a health care provider.
A confused person should not be left alone. For safety, the person may need someone nearby to calm them and protect them from injury. Rarely, physical restraints may be ordered by a health care professional.
To help a confused person:
- Always introduce yourself, no matter how well the person once knew you.
- Often remind the person of his or her location.
- Place a calendar and clock near the person.
- Talk about current events and plans for the day.
- Try to keep the surroundings calm, quiet, and peaceful.
For sudden confusion due to low blood sugar (for example, from diabetes medicine), the person should drink a sweet drink or eat a sweet snack. If the confusion lasts longer than 10 minutes, contact the provider.
When to Contact a Medical Professional
Call 911 or the local emergency number if confusion has come on suddenly or there are other symptoms, such as:
- Cold or clammy skin
- Dizziness or feeling faint
- Fast pulse
- Fever
- Headache
- Slow or rapid breathing
- Uncontrolled shivering
Also call 911 or the local emergency number if:
- This is the first time someone becomes confused for no reason
- Confusion has come on suddenly in someone with diabetes
- Confusion came on after a head injury
- The person is in danger of harming themselves or others
- The person becomes unconscious at any time
If you have been experiencing confusion, contact your provider for an appointment.
What to Expect at Your Office Visit
The doctor will do a physical examination and ask questions about the confusion. The doctor will ask questions to learn if the person knows the date, the time, and where he or she is. Questions about recent and ongoing illness, among other questions, will also be asked.
Tests that may be ordered include:
- Blood tests
- CT or MRI scan of the head
CT
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
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A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
Read Article Now Book Mark Article - Electroencephalogram (EEG)
EEG
An electroencephalogram (EEG) is a test to measure the electrical activity of the brain.
Read Article Now Book Mark Article - Lumbar puncture (spinal tap)
- Mental status tests
Mental status tests
Mental 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...
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- Urine tests
Urine tests
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
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Treatment depends on the cause of the confusion. For example, if an infection is causing the confusion, treating the infection will likely clear the confusion.
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 C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Mental status. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Siedel's Guide to Physical Examination. 10th ed. St Louis, MO: Elsevier; 2023:chap 7.
Maciel CB, Elie-Turenne M-C. Seizures. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 14.
Mendez MF, Yerstein O. Delirium. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 4.