Delirium differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vishal Khurana, M.B.B.S., M.D. [2]

Common usage of the term versus standard medical usage

In common usage, delirium is often used to refer to drowsiness and disorientation. In broader medical terminology, however, a number of other symptoms, including sudden inability of focus attention, and even (occasionally) sleeplessness and severe agitation and irritability, are also defined as "delirium."

There are several medical definitions of delirium (including those in the DSM-IV and ICD-10). However, all include some core features.

The core features are:

• Disturbance of consciousness (that is, reduced clarity of awareness of the environment, with reduced ability to focus, sustain, or shift attention)
• Change in cognition (e.g., problem-solving impairment or memory impairment) or a perceptual disturbance
• Onset of hours to days, and tendency to fluctuate.

Common features also tend to include:

• Intrusive abnormalities of awareness and affect, such as hallucinations or inappropriate emotional states.

Complete List of Differential Diagnoses

• Acidosis
• After hypoxia
• Alcohol/drug withdrawal
• Bacterial Meningitis
• Cerebral contusion
• Cerebral ischemia
• Cerebral masses
• Congestive Heart Failure (CHF)
• Dementia
• Depression
• Drug intoxication
• Hepatic encephalopathy
• HIV
• Hypoglycemia
• Pneumonia
• Postoperative and postconcussive states
• Psychotic illness
• Rheumatic Fever
• Septicemia
• Stroke
• Subarachnoid hemorrhage
• Sundowning
• Thiamine deficiency
• Thyrotoxicosis
• Toxins
• Tuberculosis
• Typhoid Fever
• Viral encephalitis