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Delirium - Delirium symptom, treatment, causes

Delirium can be defined as the acute disturbance of brain function resulting in confusion, agitation, and in severe cases delusions and hallucinations. Causes include high fever, toxins produced by bacteria in certain severe infec-tions, some poisons, drug overdosage, disturbances of the body's chemical balance such as HYPOGLYCAEMlA ( abnormally low blood sugar, and withdrawal from drug or alcohol dependence. Chronic alcoholics who suddenly stop drinking can experience delirium tremens, which is characterised by extreme agitatio, vivid hallucinations, terrors and violent trembling. In any type of delirium it is necessary to seek medical treatment.

Delirium is a condition of severe confusion and rapid changes in brain function. It is usually caused by a treatable physical or mental illness. Delirium is not a disease but a syndrome with multiple causes that result in a similar constellation of symptoms. Delirium is defined as a transient, usually reversible, cause of cerebral dysfunction and manifests clinically with a wide range of neuropsychiatric abnormalities. Because it represents a change in cognitive function, the diagnosis cannot be made without knowledge of the affected person's baseline level of cognitive function. Delirium may be caused by diseases of body systems other than the brain, by poisons, by fluid/ electrolyte or acid disturbances, and by other serious, acute conditions. Infections such as urinary tract infections or pneumonia may trigger delirium in individuals with pre-existing brain damage (prior strokes, dementia). It is a widespread condition that affects more than 50% of persons in certain high-risk population. Often the condition can be reversed, but delirium is associated with increased morbidity and mortality rates. Delirium affects at least one in ten hospitalized patients, and is a common part of many terminal illnesses. Delirium is more common in the elderly than in the general population.

Delirium usually occurs suddenly and the patient's symptoms may come and go during the day. Patients with delirium requires medical attention as soon as possible. The outlook for recovery is good if the underlying condition can be reserved, as it often can be. Patients with more severe pre-existing brain injury are more likely to develop delirium from additional illness. Other metabolic causes include diabetes mellitus, hyperthyroidism and hypothyroidism, vitamin deficiencies, and imbalances of fluids and electrolytes in the blood. The incidence is higher among young children, females, and Caucasians. Patients with delirium who are hyperactive have an increased state of arousal, psychomotor abnormalities, and hypervigilance. Medications are the most common cause of delirium in the elderly, which accounts for 22-39% of cases. In common usage, delirium is often used to refer to drowsiness and disorientation. In broader medical terminology, however, a number of other symptoms, including sudden inability of focus attention, and even sleeplessness and severe agitation and irritability, are also defined as "delirium." Treatment of delirium begins with recognizing and treating the underlying cause. Delirium itself is managed by reducing disturbing stimuli, or providing soothing ones; use of simple, clear language in communication; and reassurance, especially from family members. Physical restraints may be needed.

Causes of Delirium

The common causes and risk factor's of Delirium include the following:

• A treatable physical or mental illness.
• Medications are the most common reversible cause of delirium.
• Brain hemorrhage or infarction.
• Miscellaneous causes, such as sensory deprivation, sleep deprivation, fecal impaction, urinary retention, and change of environment.
• Unfamiliar environment.
• Low blood oxygen (hypoxemia).
• High blood carbon dioxide (hypercapnia).

Symptoms of Delirium

Some sign and symptoms related to Delirium are as follows:

• Decreased awareness of the environment.
• Illusions and misinterpreted stimuli.
• Confusion or disorientation, especially of time.
• Changes in motor activities,and movement.
• Disorientation.
• Emotional or personality changes.
• Motor abnormalities.

Treatment of Delirium

Here is list of the methods to treat Delirium:

• Giving fluids into the bloodstream to correct dehydration.
• Medications may be required to control aggressive or agitated behaviors or behaviors that are dangerous to the person.
• For the patient suspected of having alcohol toxicity or alcohol withdrawal, therapy should include multivitamins, especially thiamine.
• Medications that may worsen confusion include anticholinergics, analgesics, cimetidine, central nervous system depressants, lidocaine, and other medications (including alcohol and illegal drugs).
• In most adult patients with delirium of moderate severity, haloperidol therapy can be initiated at 1 to 2 mg twice daily, repeated every four hours as needed, and can be administered.
• Sedatives or antipsychotic drugs may be used to reduce anxiety, hallucinations, and delusions.