Delirium

by Cynthia M. Johnson, MA

Definition

Delirium is sudden confusion.

Causes

Causes of delirium are not well known. It can be caused by an injury or illness that affects the brain.

Brain Tumor

Risk Factors

Delirium is more common in older adults. Other things that may raise the risk are:

Having severe health problems, such as dementia, stroke, seizures, or tumors
Having infections, such as pneumonia or a urinary tract infection
Alcohol or drug abuse
A head injury
A severe lack of sleep or fluids
Problems passing stool

Symptoms

Symptoms happen quickly. They may be:

Memory problems
Disorientation
Being very upset
Being withdrawn
Being aggressive
Sleepiness
Language problems
Seeing, hearing, or feeling things that are not there
Believing things that are not based in reality

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. A cognitive exam will also be done. This may be enough to make the diagnosis.

These tests may be done when more information is needed:

Blood and urine tests
An MRI or CT scan to take pictures of the brain

Treatment

Most people will get better when the cause of the delirium is treated, such as treating an infection. Symptoms may also need to be treated. This can be done with:

Medicine

Some medicine may need to be stopped or changed.

Medicines to treat delirium may be:

Antipsychotics
Benzodiazepines to treat alcohol or drug withdrawal

Prevention

Delirium is hard to prevent as it starts quickly and has many causes.

RESOURCES:

American Psychiatric Association
http://www.psychiatry.org

National Institute of Mental Health
http://www.nimh.nih.gov

CANADIAN RESOURCES:

Canadian Psychiatric Association
http://www.cpa-apc.org

Canadian Psychological Association
http://www.cpa.ca

References:

Delirium in hospitalized patients. EBSCO DynaMed website. Available at: https://www.dyname.... Updated September 24, 2019. Accessed October 18, 2019.

Inouye SK, Westendorp RG, et al. Delirium in elderly people. Lancet. 2014 Mar 8;383(9920):911-22, commentary can be found in Lancet 2014 Jun 14;383(9934):2044.

4/29/2016 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Litton E, Carnegie V, et al. The efficacy of earplugs as a sleep hygiene strategy for reducing delirium in the ICU: a systematic review and meta-analysis. Crit Care Med. 2016;44(5):992-999.

Last reviewed September 2019 by EBSCO Medical Review Board Rimas Lukas, MD
Last Updated: 8/7/2020

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