Delirium (Acute Confusional State)

Question 1

What is Delirium?

Answer 1

An acute confusional state/acute organic brain syndrome.

Question 2

Risk Factors of Delirium (5).

Answer 2

1. Age > 65.
2. Background of Dementia.
3. Significant Injury e.g. Hip Fracture.
4. Frailty/Multimorbidity.
5. Polypharmacy.

Question 3

Triggers of Delirium (6).

Answer 3

1. Infection (UTI).
2. Metabolic Imbalances.
3. Change of Environment.
4. Significant Co-Morbidity.
5. Severe Pain.
6. Alcohol Withdrawal.
7. Constipation.

Question 4

Clinical Features of Delirium (7).

Answer 4

1. Memory Disturbances (especially Short-Term).
2. Agitation/Withdrawn.
3. Disorientation.
4. Mood Change.
5. Visual Hallucinations.
6. Disturbed Sleep Cycle.
7. Poor Attention.

Question 5

Delirium vs Dementia (5).

Answer 5

Delirium :

1. Impairment of Consciousness.
2. Fluctuation of Symptoms (Worse at Night).
3. Abnormal Perception (Illusion, Hallucination).
4. Agitation and Fear.
5. Delusions.

Question 6

Management of Delirium (4).

Answer 6

1. Treat Underlying Cause.
2. Modify Environment.
3. 1st Line Sedative : Haloperidol 0.5mg in Elderly People.
4. Antipsychotics can worsen Parkinsonian Symptoms - Atypical Antipsychotics are preferred.