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Acute confusional state also known as “delirium”, corresponds to a change in mental state that is characterised by being acute and reversible.
It is the result of a primary brain injury or caused by a systemic or neurological disease, intoxication or withdrawing toxic agents or drugs.
It can manifest in a very varied and striking manner, with altered attention span, altered perception, etc.
Diagnosis will be made by means of the clinical history and performing a full physical examination, including an attention test. It may be necessary to perform other laboratory or imaging tests.
Treatment is based on three prevention pillars, specific treatment and supportive treatment.
- Joseph Francis, Jr. Delirium and acute confusional states: Prevention, treatment, and prognosis. UpToDate. Aug 13, 2014.
- Clegg A, Siddiqi N, Heaven A, et al. Interventions for preventing delirium in older people in institutional long-term care. Cochrane Database Syst Rev 2014; :CD009537.
- Reston JT, Schoelles KM. In-facility delirium prevention programs as a patient safety strategy: a systematic review. Ann Intern Med 2013; 158:375.
- Van Rompaey B, Elseviers MM, Van Drom W, et al. The effect of earplugs during the night on the onset of delirium and sleep perception: a randomized controlled trial in intensive care patients. Crit Care 2012; 16:R73.
- Clegg A, Young JB. Which medications to avoid in people at risk of delirium: a systematic review. Age Ageing 2011; 40:23.
- Bird TD, Miller BL. Demencias primarias. Harrison. Manual de Medicina. 16º edición. 959-966.
- Quintero Gutiérrez del älamo, Chinchilla Moreno. El Cuadro confusional agudo. Manual de Urgencias Psiquiátricas. Capítulo 12. Pág: 299-309.
Dr. Elvira Moreno
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