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A 48-year-old female asked:

if you have a stroke, is it possible to have all your capacities one day and then be incoherent and delusional the next? for instance would you be able to see, eat talk and be coherent, and then 4 hours later be delusional and unable to even feed yoursel

2 doctor answers6 doctors weighed in
Dr. Herbert Krob
Neurology 29 years experience
While : While it is possible that a stroke could cause the symptoms you describe, there are many other possible causes. Rapidly fluctuating "incoherence" and "delusions" is a good description of a serious problem called delirium. Delirium is a very common problem in hospitalized patients and greatly contributes to the risks of hospitalization. The older or sicker patients are, the more likely they are to have delirium. About 30% of elderly patients and 80% of intensive care unit patients develop delirium. I like to say that "delirium" is not an answer, but a question. This is because delirium is not a problem in itself, but is the result of an underlying process (or usually many processes combined). There is a multitude of things that can cause delirium. These include the effects of a long list of medications, infections, inflammatory conditions, immunological conditions, organ failures, chemical imbalances, vitamin deficiencies, uncontrolled pain, seizures, changes in environment, and, yes, even strokes. Some of these conditions can also cause strokes. Treatment of delirium focuses on identifying and addressing the underlying cause. In most cases it is a good idea to avoid treating delirium with medications. It always helps to have a family member, friend, or a sitter, stay with the delirious person. (the same person doesn't have to stay around the clock. Volunteers should take turns.) other things that usually help are to make the patient's hospital stay as close to "normal life" as possible. This includes having lights on and curtains or shades open in the daytime, sitting up for meals, bringing a favorite object (like a blanket or pillow) from home, and having a night-time routine. Delirium usually reverses with the above measures, although some individuals may take a long time to get better and recovery may be incomplete. Because symptoms like you describe always indicate a serious medical problem, they should always be evaluated by a doctor.
Dr. H Robert Silverstein
Specializes in Cardiology
Yes: Stroke can do all that. Are other meds/drugs present contributing to this?
Dr. Bennett Werner
Cardiology 44 years experience
One of the cardinal manifestations of stroke is the suddenness of its onset.
Nov 25, 2013

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