Understanding Delirium

Delirium is a condition that is characterized by a sudden decline in attention, perception and mental clarity. It usually affects the mental health of a majority of the elderly but it may also affect younger individuals. Delirium is not considered as a disease in itself but rather a type of clinical syndrome or a set of symptoms brought about by an underlying disorder or disease.

Causes of delirium

The actual cause of delirium has yet to be discovered. What doctors do know is that delirium can be triggered by certain factors. Aging and a frail condition seem to play a big role in making people more vulnerable to the condition. There are also certain substances that can trigger an occurrence of the condition.

The use of certain medications seems to be the most common trigger of delirium. Certain pain medications, muscle relaxants, antidepressants, antihistamines and many others seem to trigger an episode of delirium in people. Other possible causes of delirium being considered include infections, substance withdrawal, sleep deprivation, metabolic changes in the body as well as dementia.

Symptoms of delirium

The symptoms associated with delirium are divided into three types that are based on the certain type of behavior exhibited by patients. Hyperactive delirium is characterized by a person exhibiting signs of agitation, combativeness, and irritability. It is also marked by rapid or loud speech as well as bouts of hallucinations.

A hypoactive delirium is characterized mostly by exhibiting apathy and drowsiness. Also known as the quiet delirium, people who experience it usually also seem to suddenly refrain from talking or even make movements. Then there is the mixed delirium where a patient may experience alternate bouts of being restless and being quiet.

How delirium is diagnosed?

Determining if a patient is suffering from delirium can be difficult for doctors. The usual symptoms associated with it can be quite similar to signs exhibited by other conditions such as depression, fatigue, loss of sleep as well as old age.

Possible delirium cases may need to go through a clinical evaluation which will require taking a mental status assessment of the patient, medical history, a review of medications being taken as well as a physical and a neurological exam.

How to prevent delirium?

An effective means of preventing delirium is by trying to identify the target factors that may trigger it. If the delirium is triggered by some medication, avoiding or minimizing its use can help prevent subsequent episodes. Open and clear communication with older patients can also help prevent episodes of delirium.

How to treat delirium?

Treatment of delirium initially starts with determining the underlying causes. In cases of delirium caused by an infection, treating the infection will also help take care of delirium. Supportive care usually also accompanies treatment of dementia to help manage and prevent complications.

Medications that may be used for treatment are reserved for patients who are deemed agitated or too restless enough to pose a safety risk to themselves and to others.

 

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Understanding Delirium

Delirium can be defined as an acute and sudden decline in focus of attention, as well as perception, and cognition.  On itself, delirium is not a disease, rather a clinical syndrome (or a set of symptoms), resulting from an underlying disease.  It is not synonymous with drowsiness and may occur without it. 

This is also not the same as dementia, although it commonly occurs among demented patients.  And, contrary to popular belief, people who are delirious do not have hallucinations or delusions.

The syndrome is associated with a disturbance of consciousness, such as reduced clarity of awareness of the environment. 

There are actually two varieties of dementia: 

(1) hyperactive behavior manifested by agitation or combativeness
(2) hypoactive variety manifested by the inability to converse or focus attention. 

Causes of delirium

Delirium can be caused by a structural defect or metabolic problem in the brain, as well as some psychiatric causes, which may also include mental or emotional stress, mental disease, or other programming problems. 

The syndrome can also be a result of severe physical illness or any process which interferes with the normal metabolism or function of the brain.  There is also an interaction between acute and chronic symptoms of brain dysfunction.

How delirium is diagnosed?

With careful assessment, delirium can easily be mistaken with a number of psychiatric disorders.  Delirium may be distinguished from psychosis, as the latter may not have impaired consciousness and cognition. 

The syndrome is also distinguished from dementia, as the latter is acquired and usually irreversible in nature.  It is also different from depression, as delirium is simply a case of lack of attention resulting from long-term learning disorders and varieties of congenital brain dysfunction.

How to treat delirium?

Treatment of delirium is achieved by determining the underlying cause (or causes) of this syndrome and treating it appropriately. 

Distressing symptoms of delirium are sometimes treated with antipsychotic drugs, especially those with minimal anticholinergic activity like haloperidol or risperidone. 

Non-medicating measures may also be effective in decreasing the incidence of delirium.

 

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