Acute Brain Syndrome

Overview

Delirium is a cognitive disorder characterized by a fluctuating general disorientation, accompanied by a decline in brain function, self-awareness, shifts in mood and the inability to pay attention. It affects both men and women but occurs most frequently in the elderly. Delirium is usually temporary and reversible.

Symptoms

  • amnesia (mild)
  • changes in sensation and perception
  • confusion
  • decrease in short-term memory
  • disorganized thoughts
  • disorientation
  • emotional changes: anxiety, anger, apathy, depression, euphoria, incoherence irritability
  • hallucinations
  • lack of concentration
  • lethargy
  • personality changes

Causes

Delirium is most often the result of physical or mental illness and may be caused by any of the following:

  • acid/base disturbances
  • alcoholism (delirium is a byproduct of withdrawal)
  • conditions that deprive the brain of oxygen or other substances
  • fluid and electrolyte loss
  • high fever
  • infections
  • over medication (especially in the elderly)
  • physical diseases such as heart disease, thyroid disorder, cancer, kidney or liver failure
  • poisoning by industrial chemicals or compounds such as carbon monoxide, lead and mercury
  • pre-existing brain damage from strokes or dementia
  • severe pre-existing brain injury

Treatment

Treating delirium requires a correction of any underlying health problems that may contribute to it. This can include treating an infection, reducing a fever, taking a patient off certain medications (i.e. anticholinergics, analgesics, central nervous system depressants), and correcting any electrolyte imbalance.

Certain drugs, such as haloperidol, thioridazine and risperidone may be prescribed to treat the symptoms of the delirium. As well, benzodiazepines are often needed initially to help agitated patients relax.

Psychiatric treatment may also be required to modify and control behaviour and to help reduce disorientation within a particular environment.

With treatment, delirium often lasts only about 1 week, although it may take several weeks for cognitive function to return to normal levels. In most cases, full recovery can be expected.