Delirium is sudden severe confusion due to rapid changes in brain function that occur with physical or mental illness.
Acute confusional state; Acute brain syndrome
Delirium is most often caused by physical or mental illness and is usually temporary and reversible. Many disorders cause delirium. Often, these do not allow the brain to get oxygen or other substances. They may also cause dangerous chemicals (toxins) to build up in the brain. Delirium is common in the intensive care unit (ICU), especially in older adults.
Delirium involves a quick change between mental states (for example, from lethargy to agitation and back to lethargy).
The goal of treatment is to control or reverse the cause of the symptoms. Treatment depends on the condition causing delirium. The person may need to stay in the hospital for a short time.
Stopping or changing medicines that worsen confusion, or that are not necessary, may improve mental function.
Disorders that contribute to confusion should be treated. These may include:
Treating medical and mental disorders often greatly improves mental function.
Medicines may be needed to control aggressive or agitated behaviors. These are usually started at very low dosages and adjusted as needed.
Some people with delirium may benefit from hearing aids, glasses, or cataract surgery.
Other treatments that may be helpful:
Claudia Spies is in Berlin, Germany. Spies is rated as an Elite expert by MediFind in the treatment of Delirium. She is also highly rated in 10 other conditions, according to our data. Her top areas of expertise are Delirium, Hemophagocytic Lymphohistiocytosis, Non-Langerhans-Cell Histiocytosis, and Histiocytosis.
Meera Agar is in Ultimo, Australia. Agar is rated as an Elite expert by MediFind in the treatment of Delirium. She is also highly rated in 3 other conditions, according to our data. Her top areas of expertise are Delirium, Acute Pain, Dementia, and Metastatic Brain Tumor.
Tamara Fong is a Neurologist in Newton, Massachusetts. Dr. Fong has been practicing medicine for over 24 years and is rated as an Elite doctor by MediFind in the treatment of Delirium. She is also highly rated in 7 other conditions, according to our data. Her top areas of expertise are Delirium, Dementia, Alzheimer's Disease, and Cerebellar Degeneration. She is licensed to treat patients in Massachusetts. Dr. Fong is currently accepting new patients.
Acute conditions that cause delirium may occur with long-term (chronic) disorders that cause dementia. Acute brain syndromes may be reversible by treating the cause.
Delirium often lasts about 1 week. It may take several weeks for mental function to return to normal. Full recovery is common, but depends on the underlying cause of the delirium.
Problems that may result from delirium include:
Contact your health care provider if there is a rapid change in mental status.
Treating the conditions that cause delirium can reduce its risk. In hospitalized people, avoiding or using a low dosage of sedatives, prompt treatment of metabolic disorders and infections, and using reality orientation programs will reduce the risk of delirium in those at high risk.
Published Date : November 09, 2021
Published By : Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Guthrie PF, Rayborn S, Butcher HK. Evidence-based practice guideline: delirium. J Gerontol Nurs. 2018;44(2):14-24. PMID: 29378075 www.ncbi.nlm.nih.gov/pubmed/29378075/.
Inouye SK. Delirium in the older patient. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 25.
Mendez MF, Yerstein O. Delirium. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley's and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 4.