Mental HealthPending review

Delirium

An acute, fluctuating disturbance of consciousness and attention driven by an underlying physical illness, and a medical emergency until the cause is found and treated.

In a nutshell

Delirium is global cerebral dysfunction caused by an underlying physical insult acting on arousal and attentional circuits: a relative dopaminergic/glutamatergic excess with cholinergic deficit. It is acute, fluctuating, and defined by inattention rather than memory loss, and it is a medical emergency: find and treat the cause.

Classic presentation

Acute (hours to days), fluctuating confusion with inattention and disorientation in a patient with an underlying acute illness, often worse in the evening, in either an agitated (hyperactive) or withdrawn (hypoactive) form.

Key points

Delirium is always secondary to an organic trigger: infection, hypoxia, metabolic derangement, urinary retention, constipation, pain, drugs or withdrawal are the classic reversible causes to actively search for.

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Educational content pending clinical review. Not medical advice.