Delirium causes: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Delirium}} | {{Delirium}} | ||
{{CMG}}; {{AE}} [[User:Vishal Khurana|Vishal Khurana]], M.B.B.S., M.D. [mailto:vishdoc24@gmail.com]; {{ | {{CMG}}; {{AE}} {{PB}}; [[User:Vishal Khurana|Vishal Khurana]], M.B.B.S., M.D. [mailto:vishdoc24@gmail.com];{{Vbe}} | ||
==Overview== | ==Overview== | ||
Delirium may be caused by severe physical or [[mental illness]], or any process which interferes with the normal metabolism or function of the brain | [[Delirium]] may be caused by severe physical or [[mental illness]], or any process which interferes with the normal metabolism or function of the brain such as [[fever]], [[pain]], [[poison]] ([[toxic]] [[approved drug|drug]] reactions), [[brain]] injury, [[surgery]], [[traumatic]] shock, severe lack of [[food]] or [[water]] or [[sleep]], and even withdrawal symptoms of certain [[drug]] and [[alcohol]] dependent states. In addition, there is an interaction between acute and chronic [[symptoms]] of [[brain]] dysfunction. [[Delirious]] states are more easily produced in people already suffering from underlying chronic [[brain]] dysfunction. A very common cause of [[delirium ]] in elderly people is a [[urinary tract infection]], which is easily treatable with [[antibiotics]]. | ||
[[Delirium]], like [[mental confusion]], is a very general and nonspecific symptom of [[organ]] dysfunction. In addition to many organic causes relating to a structural defect or a [[metabolic]] problem in the [[brain]], there are also some [[psychiatric]] causes, which may also include a component of [[mental]] or [[emotional]] stress, [[mental]] disease. | |||
===Life Threatening Causes=== | |||
Life-threatening causes include [[conditions]] that may result in [[death]] or permanent disability within 24 hours if left untreated.<ref name="FarahLauand2015">{{cite journal|last1=Farah|first1=Julia de Lima|last2=Lauand|first2=Carolina Villar|last3=Chequi|first3=Lucas|last4=Fortunato|first4=Enrico|last5=Pasqualino|first5=Felipe|last6=Bignotto|first6=Luis Henrique|last7=Batista|first7=Rafael Loch|last8=Aprahamian|first8=Ivan|title=Severe Psychotic Disorder as the Main Manifestation of Adrenal Insufficiency|journal=Case Reports in Psychiatry|volume=2015|year=2015|pages=1–4|issn=2090-682X|doi=10.1155/2015/512430}}</ref><ref name="CleggYoung2010">{{cite journal|last1=Clegg|first1=A.|last2=Young|first2=J. B.|title=Which medications to avoid in people at risk of delirium: a systematic review|journal=Age and Ageing|volume=40|issue=1|year=2010|pages=23–29|issn=0002-0729|doi=10.1093/ageing/afq140}}</ref> | |||
* [[Acute liver failure]] | * [[Acute liver failure]] | ||
* Acute Metabolic ([[acidosis]], [[alkalosis]], [[renal failure]], [[Electrolyte disturbance|electrolyte imbalances]]) | * Acute Metabolic ([[acidosis]], [[alkalosis]], [[renal failure]], [[Electrolyte disturbance|electrolyte imbalances]]) | ||
* Acute vascular ([[Stroke]], [[MI]], [[ | * Acute [[vascular]] disorder ([[Stroke]], [[MI]], [[pulmonary embolism]], [[heart failure]]) | ||
* [[Adrenal cortex insufficiency]] | * [[Adrenal cortex insufficiency]] | ||
* [[Altitude sickness|Acute Altitude sickness]] | * [[Altitude sickness|Acute Altitude sickness]] | ||
| Line 30: | Line 30: | ||
* [[Recreational drug use#Drugs popularly used for recreation|Toxins/drugs]] | * [[Recreational drug use#Drugs popularly used for recreation|Toxins/drugs]] | ||
* [[Recreational drug use#Drugs popularly used for recreation|Withdrawal]] | * [[Recreational drug use#Drugs popularly used for recreation|Withdrawal]] | ||
=== | |||
===List of Commonly Prescribed Medicines Attributing to [[Delirium]]=== | |||
* [[Antiarrhythmic]] | |||
* [[Antihistamine]] | |||
* [[Antiparkinsonian]] drugs such as [[benzatropine]] | |||
* [[Antispasmodic]] | |||
* [[Benzodiazepine]] | |||
* [[Diuretic]] e.g. [[Furosemide]] | |||
* Incontinence medicines e.g. [[Oxybutynin]] | |||
* [[Opioid]] Analgesics | |||
* [[Tricyclic antidepressant]].<ref name="Alagiakrishnan2004">{{cite journal|last1=Alagiakrishnan|first1=K|title=An approach to drug induced delirium in the elderly|journal=Postgraduate Medical Journal|volume=80|issue=945|year=2004|pages=388–393|issn=0032-5473|doi=10.1136/pgmj.2003.017236}}</ref> | |||
===Common Causes of [[Delirium]]=== | |||
* [[Infectious disease causes|Infections]] ([[Pneumonia]], [[Urinary Tract Infections]]) | * [[Infectious disease causes|Infections]] ([[Pneumonia]], [[Urinary Tract Infections]]) | ||
* [[Recreational drug use | * [[Recreational]] [[drug]] use,Drugs popularly used for recreation|Withdrawal]] ([[ethanol]], [[opiate]]) | ||
* Acute Metabolic ([[acidosis]], [[alkalosis]], [[renal failure]], [[Electrolyte disturbance|electrolyte imbalances]]) | * Acute Metabolic disroder ([[acidosis]], [[alkalosis]], [[renal failure]], [[Electrolyte disturbance|electrolyte imbalances]]) | ||
* [[Trauma]] ([[Pain|acute severe pain]]) | * [[Trauma]] ([[Pain|acute severe pain]]) | ||
* Central nervous system pathology ([[epilepsy]], [[cerebral hemorrhage]]) | * [[Central nervous system]] pathology ([[epilepsy]], [[cerebral hemorrhage]]) | ||
* [[Hypoxia]] | * [[Hypoxia]] | ||
* Vitamin Deficiencies ([[Vitamin_B12|vitamin B12]], [[thiamine]]) | * [[Vitamin]] Deficiencies ([[Vitamin_B12|vitamin B12]], [[thiamine]])<ref name="MavrommatiSentissi2013">{{cite journal|last1=Mavrommati|first1=K|last2=Sentissi|first2=O|title=Delirium as a result of vitamin B12 deficiency in a vegetarian female patient|journal=European Journal of Clinical Nutrition|volume=67|issue=9|year=2013|pages=996–997|issn=0954-3007|doi=10.1038/ejcn.2013.128}}</ref> | ||
* [[Endocrine diseases|Endocriopathies]] | * [[Endocrine diseases|Endocriopathies]] | ||
* Acute vascular ([[Stroke]], [[MI]], [[ | * Acute [[vascular]] disease ([[Stroke]], [[MI]], [[pulmonary embolism]], [[heart failure]]) | ||
* [[Heavy metal ingestion|Heavy metals]] | * [[Heavy metal ingestion|Heavy metals]] | ||
* [[Recreational drug use | * [[Recreational]] [[drug]] use<ref name="pmid19724721">{{cite journal |vauthors=Markowitz JD, Narasimhan M |title=Delirium and antipsychotics: a systematic review of epidemiology and somatic treatment options |journal=Psychiatry (Edgmont) |volume=5 |issue=10 |pages=29–36 |date=October 2008 |pmid=19724721 |pmc=2695757 |doi= |url=}}</ref> | ||
===Causes by Organ System=== | ===Causes by Organ System=== | ||
{|style="width:80%; height:100px" border="1" | {|style="width:80%; height:100px" border="1" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Drug Side Effect''' | | '''Drug Side Effect''' | ||
|bgcolor="Beige"|[[ | |bgcolor="Beige"|[[Antihistamines]], [[Antipsychotics]], [[Atropine]], [[Cabergoline]], [[Chloramphenicol sodium succinate]], [[Clobazam]], [[Cidofovir]], [[Drug overdose]], [[Drug withdrawal]], [[Lithium]], [[Meropenem]], [[Muscle relaxants]], [[Oxcarbazepine]], [[Promethazine]], [[Quinolones]], [[Serotonin syndrome]], [[Valproic acid]], [[Zanamivir]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Infectious Disease''' | | '''Infectious Disease''' | ||
|bgcolor="Beige"|[[Viral hemorrhagic fever]], [[Vancomycin resistant enterococcal bacteremia]], [[Urinary tract infection]], [[Typhoid fever]], [[Systemic inflammatory response syndrome]], [[Systemic infection]], [[Wound#Infection|Surgical wound infection]], [[Subdural empyema]], [[Sleeping sickness (West African)]], [[Sleeping sickness (East African)]], [[Sepsis]], [[Rickettsiae]], [[Rabies ]], [[Pyelonephritis | |bgcolor="Beige"|[[Viral hemorrhagic fever]], [[Vancomycin resistant enterococcal bacteremia]], [[Urinary tract infection]], [[Typhoid fever]], [[Systemic inflammatory response syndrome]], [[Systemic infection]], [[Wound#Infection|Surgical wound infection]], [[Subdural empyema]], [[Sleeping sickness (West African)]], [[Sleeping sickness (East African)]], [[Sepsis]], [[Rickettsiae]], [[Rabies ]], [[Pyelonephritis]], [[Plague]], [[Neurocysticercosis]], [[Malaria]], [[Central nervous system infection|Intraspinal abscess / granuloma, Intracranial abscess / granuloma]], [[Gangrene]], [[Lower respiratory tract infection classification|Chest infection]], [[Cerebral malaria]], [[Central nervous system infection|Brain or epidural abscess]], [[Brain infection]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| Line 136: | Line 149: | ||
| '''Renal/Electrolyte''' | | '''Renal/Electrolyte''' | ||
|bgcolor="Beige"|[[Hypophosphatemia]], [[Hyponatremia causes|Hypoosmolar states]], [[Hyponatremia]], [[Hypocalcemia]], [[Hyperosmolar syndrome|Hyperosmolar states]], [[Hypernatremia]], | |bgcolor="Beige"|[[Hypophosphatemia]], [[Hyponatremia causes|Hypoosmolar states]], [[Hyponatremia]], [[Hypocalcemia]], [[Hyperosmolar syndrome|Hyperosmolar states]], [[Hypernatremia]], | ||
[[Hypermagnesemia]], [[Hypercalcemia]], [[Hypomagnesemia]], [[Hyperphosphatemia]], [[ | [[Hypermagnesemia]], [[Hypercalcemia]], [[Hypomagnesemia]], [[Hyperphosphatemia]], [[Chronic renal failure]], [[Acute renal failure]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Urologic''' | | '''Urologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Urinary Track Infection]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|- | |- | ||
|} | |} | ||
===Causes in Alphabetical Order=== | ===Causes in Alphabetical Order=== | ||
{{ | {{columns-list| | ||
*[[Altitude sickness|Acute altitude sickness]] | |||
*[[Acute intermittent porphyria]] | *[[Acute intermittent porphyria]] | ||
*[[Acute liver failure]] | *[[Acute liver failure]] | ||
*[[ | *[[Acute renal failure]] | ||
*[[Adrenal cortex insufficiency]] | *[[Adrenal cortex insufficiency]] | ||
*[[Alcohol withdrawal]] | *[[Alcohol withdrawal]] | ||
*[[Antihistamines]] | *[[Antihistamines]] | ||
*[[Antipsychotics]] | *[[Antipsychotics]] | ||
| Line 184: | Line 198: | ||
*[[Lower respiratory tract infection classification|Chest infection]] | *[[Lower respiratory tract infection classification|Chest infection]] | ||
*[[Liver failure|Chronic Liver failure]] | *[[Liver failure|Chronic Liver failure]] | ||
*[[ | *[[Chronic renal failure]] | ||
*[[Coproporphyria, hereditary]] | *[[Coproporphyria, hereditary]] | ||
*[[Cushing syndrome]] | *[[Cushing syndrome]] | ||
| Line 210: | Line 224: | ||
*[[Head injury]] | *[[Head injury]] | ||
*[[Heart failure]] | *[[Heart failure]] | ||
*[[Heat stroke]] | *[[Heat stroke]] | ||
*[[Heroin]] | *[[Heroin]] | ||
| Line 254: | Line 267: | ||
*[[Meningoencephalitis]] | *[[Meningoencephalitis]] | ||
*[[Methanol]] | *[[Methanol]] | ||
*[[Toxic mushrooms|Monomethylhydrazine]] | |||
*[[Muscle relaxant]] | *[[Muscle relaxant]] | ||
*[[Neurocysticercosis]] | *[[Neurocysticercosis]] | ||
| Line 259: | Line 273: | ||
*[[Nickel|Nickel poisoning]] | *[[Nickel|Nickel poisoning]] | ||
*[[Nonconvulsive status epilepticus]] | *[[Nonconvulsive status epilepticus]] | ||
*[[Organic solvent]] | *[[Organic solvent]] | ||
*[[Phaeochromocytoma]] | *[[Phaeochromocytoma]] | ||
| Line 270: | Line 283: | ||
*[[Postictal state]] | *[[Postictal state]] | ||
*[[stress|Postoperative stress]] | *[[stress|Postoperative stress]] | ||
*[[Pyelonephritis | *[[Pyelonephritis]] | ||
*[[Quinolones]] | *[[Quinolones]] | ||
*[[Rabies]] | *[[Rabies]] | ||
| Line 290: | Line 303: | ||
*[[Multiple organ dysfunction syndrome|Systemic organ failure]] | *[[Multiple organ dysfunction syndrome|Systemic organ failure]] | ||
*[[Mescalbean|Texas Mescalbean poisoning]] | *[[Mescalbean|Texas Mescalbean poisoning]] | ||
*[[Thallium|Thallium Sulfate poisoning]] | |||
*[[Thiamine (Vitamin B1) deficiency]] | *[[Thiamine (Vitamin B1) deficiency]] | ||
*[[Thrombocytosis]] | *[[Thrombocytosis]] | ||
*[[Toluene]] | *[[Toluene]] | ||
*[[Trauma]] | *[[Trauma]] | ||
*[[Typhoid fever]] | *[[Typhoid fever]] | ||
| Line 308: | Line 320: | ||
*[[Wilson's disease]] | *[[Wilson's disease]] | ||
*Withdrawal states e.g. [[ethanol]], [[benzodiazepines]] | *Withdrawal states e.g. [[ethanol]], [[benzodiazepines]] | ||
*[[Zanamivir]] | |||
}} | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 07:13, 22 April 2021
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Delirium Microchapters |
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Diagnosis |
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Treatment |
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Delirium On the Web |
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American Roentgen Ray Society Images of Delirium |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Pratik Bahekar, MBBS [2]; Vishal Khurana, M.B.B.S., M.D. [3];Vindhya BellamKonda, M.B.B.S [4]
Overview
Delirium may be caused by severe physical or mental illness, or any process which interferes with the normal metabolism or function of the brain such as fever, pain, poison (toxic drug reactions), brain injury, surgery, traumatic shock, severe lack of food or water or sleep, and even withdrawal symptoms of certain drug and alcohol dependent states. In addition, there is an interaction between acute and chronic symptoms of brain dysfunction. Delirious states are more easily produced in people already suffering from underlying chronic brain dysfunction. A very common cause of delirium in elderly people is a urinary tract infection, which is easily treatable with antibiotics. Delirium, like mental confusion, is a very general and nonspecific symptom of organ dysfunction. In addition to many organic causes relating to a structural defect or a metabolic problem in the brain, there are also some psychiatric causes, which may also include a component of mental or emotional stress, mental disease.
Life Threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.[1][2]
- Acute liver failure
- Acute Metabolic (acidosis, alkalosis, renal failure, electrolyte imbalances)
- Acute vascular disorder (Stroke, MI, pulmonary embolism, heart failure)
- Adrenal cortex insufficiency
- Acute Altitude sickness
- Brain infection
- Decompression sickness
- Gangrene
- Head injury
- Hyperosmolar non-ketotic diabetic coma
- Hyperthermia
- Hypoglycemia
- Hypothermia
- Hypoxia
- Hypoxemia
- Raised intracranial pressure
- Rickettsiae
- Sepsis
- Toxins/drugs
- Withdrawal
List of Commonly Prescribed Medicines Attributing to Delirium
- Antiarrhythmic
- Antihistamine
- Antiparkinsonian drugs such as benzatropine
- Antispasmodic
- Benzodiazepine
- Diuretic e.g. Furosemide
- Incontinence medicines e.g. Oxybutynin
- Opioid Analgesics
- Tricyclic antidepressant.[3]
Common Causes of Delirium
- Infections (Pneumonia, Urinary Tract Infections)
- Recreational drug use,Drugs popularly used for recreation|Withdrawal]] (ethanol, opiate)
- Acute Metabolic disroder (acidosis, alkalosis, renal failure, electrolyte imbalances)
- Trauma (acute severe pain)
- Central nervous system pathology (epilepsy, cerebral hemorrhage)
- Hypoxia
- Vitamin Deficiencies (vitamin B12, thiamine)[4]
- Endocriopathies
- Acute vascular disease (Stroke, MI, pulmonary embolism, heart failure)
- Heavy metals
- Recreational drug use[5]
Causes by Organ System
Causes in Alphabetical Order
- Acute altitude sickness
- Acute intermittent porphyria
- Acute liver failure
- Acute renal failure
- Adrenal cortex insufficiency
- Alcohol withdrawal
- Antihistamines
- Antipsychotics
- Brain abscess
- Brain infection
- Brain or epidural abscess
- Brain tumor
- Burns
- Cabergoline
- Carbon monoxide toxicity
- Carbon tetrachloride
- Cardiac failure
- Cerebral infarction
- Cerebral malaria
- Cerebral oedema
- Cerebrovascular accident
- Chest infection
- Chronic Liver failure
- Chronic renal failure
- Coproporphyria, hereditary
- Cushing syndrome
- Cyanide
- Daphne poisoning
- Decompression sickness
- Diabetic hypoglycemia
- Diabetic ketoacidosis
- Drug overdose
- Drug withdrawal
- Electric shock
- Elevated or depressed adrenal function
- Elevated or depressed pancreas function
- Elevated or depressed pituitary function
- Encephalitis
- Encephalitis
- Epidural haemorrhage
- Epileptic seizures
- Ethanol
- Ethylene glycol
- Fat embolism
- Folate deficiency
- Gangrene
- Hallucinogens
- Head injury
- Heart failure
- Heat stroke
- Heroin
- Hperthyroidism
- Hpherphosphatemia
- Hydrogen sulfide
- Hyomagnesemia
- Hyperbaric sickness
- Hypercalcemia
- Hypercarbia
- Hypereosinophilia
- Hyperglycemia
- Hypermagnesia
- Hypernatremia
- Hyperosmolar non-ketotic diabetic coma
- Hyperosmolar states
- Hypertensive encephalopathy
- Hyperthermia
- Hyperthyroid
- Hypocalcemia
- Hypoglycemia
- Hyponatremia
- hypoosmolar states
- Hypophosphatemia
- Hypopituitarism
- Hypothermia
- Hypothyroidism
- Hypoxemia
- Hypoxia
- Infections
- Intracranial abscess / granuloma
- Intracranial bleeding
- Intraspinal abscess / granuloma
- Jimson weed
- Lead
- Leukemic blast cell crisis
- Lithium
- Liver failure
- Malaria
- Malignant hypertension
- Marijuana
- Meningitis
- Meningoencephalitis
- Methanol
- Monomethylhydrazine
- Muscle relaxant
- Neurocysticercosis
- Niacin deficiencies
- Nickel poisoning
- Nonconvulsive status epilepticus
- Organic solvent
- Phaeochromocytoma
- Phencyclidine
- Pituitary apoplexy
- Plague
- Poison hemlock
- Polycythemia
- Porphyria
- Postictal state
- Postoperative stress
- Pyelonephritis
- Quinolones
- Rabies
- Raised intracranial pressure
- Renal failure, acute
- Renal failure, chronic
- Respiratory failure
- Rickettsiae
- Schizoaffective disorder
- Sepsis
- Serotonin syndrome
- Skull fracture
- Sleeping sickness (East African)
- Sleeping sickness (West African)
- Subdural empyema
- Surgical wound infection
- Systemic infection
- systemic inflammatory response syndrome
- Systemic organ failure
- Texas Mescalbean poisoning
- Thallium Sulfate poisoning
- Thiamine (Vitamin B1) deficiency
- Thrombocytosis
- Toluene
- Trauma
- Typhoid fever
- Urinary tract infection
- Valproic acid
- Vancomycin resistant enterococcal bacteremia
- Vasculitis
- Venous sinus thrombosis
- Viral hemorrhagic fever
- Vitamin B12 deficiency
- Water hemlock poisoning
- Wernicke's encephalopathy
- Wilson's disease
- Withdrawal states e.g. ethanol, benzodiazepines
- Zanamivir
References
- ↑ Farah, Julia de Lima; Lauand, Carolina Villar; Chequi, Lucas; Fortunato, Enrico; Pasqualino, Felipe; Bignotto, Luis Henrique; Batista, Rafael Loch; Aprahamian, Ivan (2015). "Severe Psychotic Disorder as the Main Manifestation of Adrenal Insufficiency". Case Reports in Psychiatry. 2015: 1–4. doi:10.1155/2015/512430. ISSN 2090-682X.
- ↑ Clegg, A.; Young, J. B. (2010). "Which medications to avoid in people at risk of delirium: a systematic review". Age and Ageing. 40 (1): 23–29. doi:10.1093/ageing/afq140. ISSN 0002-0729.
- ↑ Alagiakrishnan, K (2004). "An approach to drug induced delirium in the elderly". Postgraduate Medical Journal. 80 (945): 388–393. doi:10.1136/pgmj.2003.017236. ISSN 0032-5473.
- ↑ Mavrommati, K; Sentissi, O (2013). "Delirium as a result of vitamin B12 deficiency in a vegetarian female patient". European Journal of Clinical Nutrition. 67 (9): 996–997. doi:10.1038/ejcn.2013.128. ISSN 0954-3007.
- ↑ Markowitz JD, Narasimhan M (October 2008). "Delirium and antipsychotics: a systematic review of epidemiology and somatic treatment options". Psychiatry (Edgmont). 5 (10): 29–36. PMC 2695757. PMID 19724721.