Sudden Confusion (Delirium)

Sudden confusion, also known as delirium, is a serious disturbance in mental abilities that results in confused thinking and reduced awareness of the environment. The onset of delirium is usually rapid, and it can fluctuate throughout the day.

Causes

• Infections (e.g., pneumonia, urinary tract infections)
• Medications (e.g., sedatives, antidepressants, antihistamines)
• Withdrawal from alcohol or drugs
• Dehydration and electrolyte imbalances
• Pain
• Sleep deprivation
• Medical conditions (e.g., stroke, seizures, hypoglycemia)
• Surgery and anesthesia

Symptoms

• Sudden onset of confusion
• Disorganized thinking and speech
• Difficulty paying attention and focusing
• Memory problems
• Mood changes (e.g., agitation, anxiety, aggression)
• Changes in sleep patterns
• Fluctuating levels of consciousness

Risk Factors

• Older age
• Prior cognitive impairment (e.g., dementia)
• Chronic medical conditions (e.g., diabetes, heart disease)
• History of substance abuse
• Medication use (e.g., sedatives, anticholinergics)

Diagnosis

Delirium is diagnosed based on a combination of clinical evaluation, medical history, and laboratory tests. The diagnosis is typically made by a healthcare professional using the following criteria:

• Disturbance in attention (e.g., difficulty focusing)
• Change in cognition (e.g., memory problems, disorganized thinking)
• Development of symptoms over a short period (usually hours to days)
• Fluctuating course of symptoms

Treatment

Treatment for delirium focuses on addressing the underlying cause and managing symptoms. This may include:

• Discontinuing or adjusting medications that may be contributing to delirium
• Treating underlying medical conditions (e.g., infections, pain)
• Providing a supportive environment (e.g., reducing noise and stress)
• Encouraging sleep and hydration
• Using medications to manage symptoms (e.g., agitation, aggression) if necessary

Prognosis

The prognosis for delirium varies depending on the underlying cause and the individual's overall health. With prompt treatment, some people can recover fully from delirium, while others may experience persistent cognitive impairment or increased risk of future episodes.