# delirium | Symptoms, Causes, Tests and Treatment | OSANG > Delirium is a disorder of attention and consciousness that appears acutely over several hours to several days, and is characterized by symptoms that fluctuate throughout… - Official page: https://osns.co.kr/en/encyclopedia/delirium - Organization: OSANG Neurosurgery ## Page content Neurological Conditions ## delirium Delirium · F05 Delirium is a disorder of attention and consciousness that develops acutely and fluctuates throughout the day. It is a reversible brain dysfunction caused by physical causes such as infection, drugs, and metabolic abnormalities. ## At a glance Delirium is a disorder of attention and consciousness that appears acutely over several hours to several days, and is characterized by symptoms that fluctuate throughout the day. It occurs in a significant number of hospitalized elderly people, reaching up to half in some groups such as patients after surgery or in intensive care units. Confusion Assessment Method (CAM) is a representative screening tool. Unlike dementia, it develops acutely and can be recovered if the cause is corrected, but hypoactive delirium, which causes decreased activity, is easy to miss. - 01Definition and Overview - 02Differentiation from dementia - 03cause - 04Subtype - 05diagnosis - 06Prevention and Treatment ## Definition and Overview Delirium is a brain dysfunction centered on impairment of attention and consciousness that develops acutely and fluctuates throughout the day. The ability to concentrate, maintain, and shift attention is reduced, and is accompanied by impairments in memory, perception, language, and perception. In ICD-10, it is classified as F05. Delirium is not a disease with a single cause, but a syndrome that occurs when physical abnormalities affect brain function. Triggers include infection, drugs, metabolic abnormalities, and surgery, and even the same stimulus occurs more easily in patients who are elderly or have underlying cognitive decline. It occurs in a significant number of hospitalized elderly people, and in some groups, such as patients after surgery or in intensive care units, it occurs in up to half. ## Differentiation from dementia Delirium and dementia both show cognitive decline, but the course and reversibility are different. - Onset: Delirium begins acutely within hours to days, and dementia progresses slowly over months to years. - Progress: Delirium fluctuates significantly throughout the day, while dementia progresses relatively steadily. - Attention/Consciousness: In delirium, decreased attention and changes in the level of consciousness are noticeable, but in dementia, consciousness is relatively maintained in the early to middle stages. - Reversibility: Delirium is usually recovered when the cause is corrected, but degenerative dementia is progressive. It is common for dementia patients to experience overlapping delirium, and in this case, the guardian's information is used to check whether there has been an acute deterioration in the usual cognitive state. ## cause Delirium is often caused by several factors working together. - Infections: pneumonia, urinary tract infection, sepsis - Medications: anticholinergics, benzodiazepines, opioids, polypharmacy, drug withdrawal - Metabolic abnormalities: dehydration, electrolyte imbalance, hypoglycemia/hyperglycemia, hypoxia, liver/kidney dysfunction - Surgery/Trauma: Post-operative condition, anesthesia, pain - Environment/Other: Constipation, urinary retention, sleep deprivation, sensory block, physical inhibition Old age, existing cognitive decline, severe illness, and impaired vision and hearing are vulnerable factors that can cause delirium even with little stimulation. ## Subtype Delirium is divided into three subtypes depending on psychomotor activity. - Hyperactivity: Shows agitation, excitement, hallucinations, and aggression. Relatively easy to find. - Hypoactivity: Shows drooping, drowsiness, and decreased responsiveness. Because it looks quiet, it can easily be mistaken for depression or fatigue and is easy to miss. - Mixed: Both aspects appear alternately. Hypoactive delirium tends to have a worse prognosis and requires active screening. ## diagnosis Diagnosis is based on clinical evaluation. Confusion Assessment Method (CAM) is a representative screening tool that evaluates acute onset and fluctuating course, decreased attention, disorganization of thinking, and changes in level of consciousness. In addition to screening, medical history and medication review, blood tests (electrolytes, blood sugar, kidney, liver function, and inflammation indicators), urine tests, and, if necessary, brain imaging and electroencephalography are performed to find the triggering cause. ## Prevention and Treatment The key to prevention and treatment is correction of triggering factors and non-pharmacological approaches. - Cause correction: Infection treatment, fluid and electrolyte correction, adjustment of causative medication, management of pain, constipation, and urinary retention. - Non-pharmacological treatment: orientation support, provision of glasses and hearing aids, maintenance of daytime activities and nighttime sleep, early mobilization, family involvement, and minimization of physical restraint. - Pharmacological treatment: Antipsychotics are used short-term and in small doses only for severe agitation that cannot be controlled with non-pharmacological treatment and poses a risk to oneself or others. Patients who experience delirium have a high risk of subsequent cognitive decline, prolonged hospitalization, and complications, so early detection and prevention are important. ## Frequently asked questions ### Q01What is the difference between delirium and dementia? Delirium begins acutely within a few hours to a few days, symptoms worsen and fluctuate throughout the day, and it is difficult to concentrate and usually recovers when the cause is corrected. Dementia progresses slowly over months to years, and consciousness is relatively maintained. However, delirium may also occur in dementia patients. ### Q02Why does delirium occur? It is caused by many physical causes, including infection (pneumonia, urinary tract infection), dehydration and electrolyte abnormalities, drug side effects, surgery and anesthesia, pain, constipation and urinary retention, and sleep deprivation. It is more likely to occur even with little stimulation if you are old, have cognitive decline, or have poor vision or hearing. ### Q03Is it delirium to just sit still? That's right. Delirium is divided into hyperactivity, in which the person is excited and anxious, and hypoactivity, in which the person becomes drowsy, drowsy, and unresponsive. Hypoactive delirium appears quiet, so it can easily be mistaken for depression or simple fatigue and is easy to miss. If you feel dazed and unfocused than usual, you should suspect delirium. ### Q04How is delirium diagnosed? Confusion Assessment (CAM) is a representative screening tool that evaluates acute onset and fluctuation, decreased attention, disorganization of thinking, and changes in level of consciousness. Along with diagnosis, blood tests, urine tests, and drug reviews are performed to find causes such as infections, drugs, and metabolic abnormalities. ### Q05Is delirium reversible? In most cases, recovery occurs when the causing cause is corrected. However, if you are elderly or have existing cognitive decline, recovery may be slow, and in some cases, symptoms may remain for a long time. Patients who experience delirium are at high risk of subsequent cognitive decline and complications, so early detection and correction of the cause are important. ### Q06Is delirium preventable? Non-pharmacological approaches to reduce triggering factors are effective. Sufficient hydration and nutrition, pain control, use of glasses and hearing aids, orienting support that tells time and place, maintaining daytime activities and sleeping at night, and minimizing unnecessary drugs and physical restraint are helpful. Drugs are used limitedly after correction of the cause and non-pharmacological treatment. ## Related articles - Cervical radiculopathy - Cervical disc herniation - dystonia - Orthostatic hypotension This article provides general medical information and does not replace an individual diagnosis or treatment plan. Please seek a medical assessment if symptoms persist. ## Important notice This Markdown alternative helps search and AI tools understand the public page accurately. It provides general health information and does not replace an individual diagnosis or treatment.