Delirium

Question 1

Delirium can be cortically and subcortically mediated in terms of its pathophysiology.

List the principle functional cortical areas (5½)

Answer 1

Broca’s motor speech area (½), Wernicke’s auditory association area (½), primary motor area (½), primary sensory area (½), motor association area (½), sensory association area (½), prefrontal cortex (½), frontal eye field (½), primary auditory cortex (½), primary visual cortex (½), limbic association cortex (½)

Question 2

Define delirium (2)

Answer 2

Clinical syndrome of confusion, variable degree of clouding of consciousness, visual illusions, and/or visual hallucinations, lability of affect, and disorientation.

Question 3

Metabolic disturbance is one of the common causes of delirium. Outline the DSM IV diagnostic criteria for delirium due to a general medical condition (8)

Answer 3

Disturbance of consciousness with reduced ability to sustain, focus or shift attention.

Change in cognition e.g. Memory deficit, disorientation, language disturbance.

Disturbance develops over short period generally hours to days and tends to fluctuate during the course of the day.

Evidence from the history, physical examination or laboratory findings that disturbance caused by the physiological consequences of a general medical condition.