Delirium

Abstract

Delirium is a clinical diagnosis characterized by transient, usually reversible, cerebral dysfunction which develops over a short period of time. It can occur at any age but is seen more often in individuals over the age of 65 as well as those with compromised mental status, such as patients with dementia. The cardinal features of delirium include decreased attention, and “waxing and waning” orientation. Diagnosis is obtained from a careful history, from collateral sources such as family and caregivers, and cognitive exam. There is no laboratory test or study to diagnose delirium but studies can help identify the underlying cause. There are various screening tools for delirium which can be helpful in the ED.

There are two forms of delirium: hypoactive, presenting as withdrawn (very similar to retarded catatonia) and hyperactive, presenting as agitated, with heightened arousal and hypervigilance.