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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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