Acute Confusional State : Symptoms, Causes, Diagnosis, and Treatment
Symptoms:
- Sudden onset of confusion
- Difficulty focusing or paying attention
- Disorganized thinking
- Rapid mood changes
- Hallucinations or delusions
- Memory problems, particularly short-term
- Changes in sleep patterns (e.g., sleeping during the day and awake at night)
- Agitation or lethargy
Causes:
- Infections (e.g., urinary tract infections, pneumonia)
- Medication side effects or drug interactions
- Withdrawal from alcohol or drugs
- Metabolic imbalances (e.g., low sodium, high calcium)
- Severe chronic illness or terminal illness
- Surgery or anesthesia
- Pain
- Dehydration or malnutrition
- Brain disorders (e.g., dementia, stroke)
- Sleep deprivation
Diagnosis:
- Medical history and physical examination
- Cognitive assessments (e.g., Confusion Assessment Method)
- Laboratory tests (blood tests, urine analysis)
- Imaging studies (CT scan, MRI) to rule out structural abnormalities
- Electroencephalogram (EEG) if seizures are suspected
Treatment:
- Address underlying causes (e.g., treat infections, correct metabolic imbalances)
- Review and adjust medications
- Hydration and nutrition support
- Provide a calm and safe environment
- Orientation aids (e.g., clocks, calendars, family photos)
- Minimize use of restraints and invasive devices
- Medications may be used to manage severe agitation (e.g., antipsychotics)
- Supportive care and monitoring
Preventive measures include proper management of chronic conditions, avoiding polypharmacy, ensuring adequate hydration and nutrition, and maintaining regular sleep patterns.