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Doctor insights on: Delirium

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Dr. Maureen Nash
368 Doctors shared insights

Delirium (Overview)

We believe delirium occurs when the brain cannot maintain its normal activities when overwhelmed by metabolic demands or other variables which exceed the brain's capacity to compensate for. Brains with less reserve capacity are particularly vulnerable. Not entirely unlike acute heart failure. See my last textbook chapter for more reading in the appi textbook of psychiatry (5th ed).


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Why does a urinary tract infection cause delirium?

Why does a urinary tract infection cause delirium?

Great question: We believe delirium occurs when the brain cannot maintain its normal activities when overwhelmed by metabolic demands or other variables which exceed the brain's capacity to compensate for. We do not know why uti's precipitate delirium in vulnerable older adults. We do know fever increases the oxidative requirements of the brain, and cytokines released during infection may play a role. ...Read more

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Dr. Maureen Nash
368 Doctors shared insights

Delirium (Overview)

We believe delirium occurs when the brain cannot maintain its normal activities when overwhelmed by metabolic demands or other variables which exceed the brain's capacity to compensate for. Brains with less reserve capacity are particularly vulnerable. Not entirely unlike acute heart failure. See my last textbook chapter for more reading in the appi textbook of psychiatry (5th ed).


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Can docs explain what does the word delirium mean?

Off track: Lethargus and Phrenitus are the ancient terms. Precipitants initiate a cascade of neurochemical and metabolic brain events that disturb the normal functioning of the brain. "Brain insufficiency or failure" akin to heart failure. Not cell death, but cell strain. Brain cells can no longer perform their normal function but are not so taxed that they are actively dying.
...Read more

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What kind of doctor treats hypoactive delirium, a neurologist or a psychiatrist?

Try geriatrician: Geriatrician is very capable of managing delirium. They train with psychiatrist and neurologist during the residency and fellowship. They are able to identify the cause of the delirium and to treat appropriately with proper follow ups or continuum of care. ...Read more

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How is delirium treated?

How is delirium treated?

Treat cause: Delireum can be caused by alot of things.
Infection, medication, anesthesia? It's a pretty long list. You have to treat the underlying cause. ...Read more

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What is delirium nocturnum?

Not common term: Literally, confusion at night. Many illnesses have increased symptoms at night includg dementia where the term sundowning is used. ...Read more

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Does home treatment affect delirium?

Depends: If we are considering acute brain failure delirium unlinked to drug or alcohol withdrawal states, then the home environment can be helpful as it is more "orienting" and familiar to a confused person. This may help reduce distress. Home treatment can also worsen delirium if medications are not administered correctly, or if some otcs like Benadryl (diphenhydramine) are used. ...Read more

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What are some common treatments for delirium?

It varies a lot: Frequent redirection and orientation. Ensureing adequate hydration. Reducing overstimulation. Special sense evaluation such as making sure patients have their teeth, hearing aids. Avoiding drugs known to be associated with delirium. Appropriate drug therapy with antipsychotics as first line, especially haloperidol. ...Read more

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What's the best treatment to get rid of delirium tremens?

DTs: To prevent serious damage and seizures, vitamins and benzodiazepine, fluids, and other supportive therapies. Some physicians use Phenobarbital to help with withdrawal. ...Read more

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Can delirium be prevented?

Yes and no: Delirium due to "acute brain failure" as opposed to drug or alcohol withdrawal does have some known and modifiable precipitants. Elderly adults with pre-existing brain atrophy are perhaps the most vulnerable. Several studies have been done in the past 15 years looking at mitigating delirium risk via " delirium prophylaxis". Stanford and perhaps vanderbilt are leaders in this. ...Read more

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Why do some people (mainly old people) get delirium when they have a UTI? How does that happen? Why?

Out of balance: You hate to think of it this way, but when we get old the body (and mind) can become very frail. Many older folk have shrinkage of brain tissue/ some elements of cognitive decline whether it is recognized or not. Add a UTI to that and u can really throw your patient for a loop. With younger folk u rarely see this unless very severe-like sepsis. Once UTI is well treated, expect patient to recover. ...Read more

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What is delirium?

What is delirium?

Delirium: Delirium is with acute onset & change in level of consciousness. ...Read more

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How is delirium treated?

Treat cause: Delireum can be caused by alot of things.
Infection, medication, anesthesia? It's a pretty long list. You have to treat the underlying cause. ...Read more

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How is delirium diagnosed?

How is delirium diagnosed?

Delirium: Delirium is a clinical diagnosis, usually made in the context of other underlying medical conditions. Mental status changes within hours to days from normal waking to confusion ; reduced awareness of the environment. Activity level can be agitated to stuporous, even progressing to coma if the cause is not found and addressed. Multiple assessment scales exist also: http://tinyurl. Com/nyh77jo. ...Read more

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What is delirium nocturnum?

Not common term: Literally, confusion at night. Many illnesses have increased symptoms at night includg dementia where the term sundowning is used. ...Read more

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What is a cause of delirium?

What is a cause of delirium?

There are many: Delirium is a syndrome that involves confusion, poor attention, disturbance in sleep wake cycles, psychosis and other symptoms. It is most often seen in seeverely ill people who are hospitalized. Drug use and drug withdrawl can also cause it. Sleep deprivation, electrolyte disturbance, low oxygen/glucose etc can cause it. People with dementia and other brain pathology are at highest risk. ...Read more

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Can pain make delirium worse?

Can pain make delirium worse?

Absolutely!: Very ill or aged folk can have delirium triggered by minor additional symptoms and pain is a common one. Management can be difficult w/out extreme sedation and that can risk or hasten death. But it can pass - it is a mental state - not a disease in itself. Try to keep the situation as calm and peaceful as possible. Try to recall the good times and stories of such a long life - that might help. ...Read more

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What are the complications of delirium?

What are the complications of delirium?

Depends: What casued the delerium? Anesthesia? It usually passes in hrs. Psych meds? Surgery, lsd, stroke, altzheimers, depending on the cause the complications are anything you can think of if a person isn't thinking right;, hurting others or themselves, malnutrition or any organ can fail with long term delirum. ...Read more

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What causes someone to have acute delirium?

Depends: We believe delirium occurs when the brain cannot maintain its normal activities when overwhelmed by metabolic demands or other variables which exceed the brain's capacity to compensate for. Brain with less reserve capacity are more vulnerable. Not entirely unlike acute heart failure. This is different than delirium tremens which is caused by neurochemical changes from drug/etoh withdrawl. ...Read more

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