Verified By Apollo Hospitals October 1, 2024
In delirium the brain trips and fumbles. Delirium is a change in the functioning of the brain that results in confused thinking and reduced awareness of the environment. It is common and can be cured. Usually, the start of delirium is fast — within hours or some days.
A sudden change in a person’s mental faculties (how well the brain is functioning) causing confusion, disorientation and even impaired consciousness is described as delirium. It is a common disorder and may be seen in association with other psychiatric conditions.
There are many causes of delirium:
Psychiatric symptoms: Disturbances in sleep – wake cycle, mood swings, abnormal behaviour, hallucinations and delusions, agitation, irritability, anxiety, depression. The person may be drowsy in the day as their night sleep is for a short duration and fragmented.
Neurological symptoms: Tremors, incontinence (inability to control urine), lack of coordination while walking, impairment in consciousness.
Impairment of cognitive functions: Problem in understanding speech, loss of recent memory, difficulties in reading, writing, speaking and disorientation.
Inability to stay in the present: Wandering attention, inability to respond to questions, getting distracted frequently, lack of focus.
The symptoms of delirium occur suddenly and may last for hours or days. The symptoms keep changing so it is important for the relatives of the person to note them down, or they may be missed.
Delirium may be confused with dementia but there are some differences. For instance, dementia has a gradual onset while delirium is immediate. Also, in dementia, alertness is present in the early stages, while in delirium, alertness and memory loss is significant.
The symptoms may be fewer during the day, but at night they are severe. This is called ‘sun downing.’
While diagnosing delirium, it is important to know the history of the medication the person is on, if there is alcohol/drug abuse, if he is HIV positive and if he has any major medical conditions. Also, it is helpful to know if there are changes in his behaviour, mood and other mental functions. A complete neurological and psychiatric evaluation is of paramount importance.
The treatment of the cause is of primary importance as symptoms rapidly improve once the cause is treated.
Any electrolyte or nutritional imbalances must be corrected.
Psychiatric treatment for accompanying psychiatric illnesses is recommended – for e.g. antipsychotics to control irritability and agitation.
It is important to identify what triggers delirium, especially if the patient is hospitalised. Correction of fluid and electrolyte imbalance, avoiding loud noises, getting adequate fresh air and good diet are all important.
It is also important to place a clock where the time can be easily seen, place a calendar in the room and have the person surrounded with people he is close to.
A person having episodes of delirium needs constant care and support of his near and dear ones, especially if he has a terminal illness such as AIDS or untreatable cancer. Some tips are as follows:
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