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  • Vidyasagar Vangala

Delirium

Delirium is a common condition in geriatric age group, which is many times undiagnosed/under diagnosed and may lead to painful and serious complication, even death in 1/3 of patients who suffer delirium.

Definition: A disturbance in attention and awareness, and change in cognition developing over a short period of time, which fluctuates during the course of the day. Signs and symptoms include: Disorientation, Illusion, Hallucination and Fluctuating levels of consciousness Causes: Hypoxia due to many reasons, medication side effects ( example: anticholinergics), head injury, CVA ( stroke), MI ( heart attack), fractures and falls ( example: hip fracture), withdrawal from drugs, alcohol or certain medication, post surgical ( heart bypass, hip surgery, GI surgeries etc.), infections (UTI), Electrolyte and metabolic changes ( example: low sodium, Hypo or hyperglycemia), Sensory Deprivation, Brain tumors or metastatic lesions in the brain and many more Treatment: The best treatment for Delirium is to identify and correct the underlying pathology or etiological factors contributing to the delirium. In some situations medication such as anti cholinesterase's, short acting BZD, atypical antipsychotic used carefully may benefit and decrease the behavioral problems. Avoid physical restraints.



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