Delirium other diagnostic studies: Difference between revisions

Jump to navigation Jump to search
← Older editNewer edit →
VisualWikitext
Pratik Bahekar (talk | contribs)
nocaptcha
3,696 edits
Pratik Bahekar (talk | contribs)
nocaptcha
3,696 edits
No edit summary
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Delirium}}
{{Delirium}}
{{CMG}}; {{AE}} [[User:Vishal Khurana|Vishal Khurana]], M.B.B.S., M.D. [mailto:vishdoc24@gmail.com]
{{CMG}}; {{AE}} [[User:Vishal Khurana|Vishal Khurana]], M.B.B.S., M.D. [mailto:vishdoc24@gmail.com]; {{PB}}


==Overview==
==Overview==
Line 7: Line 7:


To identify underlying etiology following investigations are recommended:
To identify underlying etiology following investigations are recommended:


* Complete blood count
* Complete blood count
Line 28: Line 27:


'''If indicated:
'''If indicated:
** EEG
*EEG


** CT head
*CT head


** B12 and folate levels
*B12 and folate levels


** Arterial blood gases
*Arterial blood gases


** Specific cultures eg urine, sputum
*Specific cultures eg urine, sputum


** Lumbar puncture
*Lumbar puncture


===EEG===
===EEG===


Although the EEG is frequently abnormal in those with delirium [27‑29], showing diffuse slowing, its routine use as a diagnostic tool has not been fully evaluated. EEG may be useful where there is difficulty in the following situations (grade III):
EEG shows diffuse slowing. EEG is useful to differentiate delirium from following condtions:


·                    Differentiating delirium from dementia
*dementia


·                    Differentiating delirium from non‑convulsive status epilepticus and temporal lobe epilepsy
*non‑convulsive status epilepticus and temporal lobe epilepsy


·                    Identifying those patients in whom the delirium is due to a focal intracranial lesion, rather than a global abnormality.
*focal intracranial lesion, or it's a global abnormality.
 
EEG is not used to diagnose delirium.


===Lumbar puncture===
===Lumbar puncture===
 
Routine LP does not provide any benefit in management of delirium. However,it's helpful in suspected meningitis, ie delirium with
Although various abnormalities have been seen in the CSF of patients with delirium [30], routine LP is not helpful [31] in identifying an underlying cause for the delirium (grade III). It should therefore be reserved for those in whom there is reason to suspect a cause such as meningitis. This might include patients with the following features:
* Meningism
 
* Headache and fever<ref>{{Cite web  | last =  | first =  | title = http://www.bgs.org.uk/Word%20Downloads/delirium.doc | url = http://www.bgs.org.uk/Word%20Downloads/delirium.doc | publisher =  | date =  | accessdate =}}</ref>
·                    Meningism
 
·                    Headache and fever<ref>{{Cite web  | last =  | first =  | title = http://www.bgs.org.uk/Word%20Downloads/delirium.doc | url = http://www.bgs.org.uk/Word%20Downloads/delirium.doc | publisher =  | date =  | accessdate =}}</ref>


==References==
==References==

Revision as of 18:34, 14 February 2014

Delirium Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Delirium from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

CT

MRI

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case #1

Delirium On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Delirium

All Images
X-rays
Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Delirium

CDC on Delirium

Delirium in the news

Blogs on Delirium

Directions to Hospitals Treating Delirium

Risk calculators and risk factors for Delirium

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]; Pratik Bahekar, MBBS [3]

Overview

Investigations

To identify underlying etiology following investigations are recommended:

  • Complete blood count
  • Serum Calcium
  • Kidney function tests
  • electrolytes
  • Liver function tests
  • Blood sugar level
  • Thyroid function tests
  • Chest X‑ray
  • ECG
  • Blood cultures
  • Urinalysis


If indicated:

  • EEG
  • CT head
  • B12 and folate levels
  • Arterial blood gases
  • Specific cultures eg urine, sputum
  • Lumbar puncture

EEG

EEG shows diffuse slowing. EEG is useful to differentiate delirium from following condtions:

  • dementia
  • non‑convulsive status epilepticus and temporal lobe epilepsy
  • focal intracranial lesion, or it's a global abnormality.

EEG is not used to diagnose delirium.

Lumbar puncture

Routine LP does not provide any benefit in management of delirium. However,it's helpful in suspected meningitis, ie delirium with

  • Meningism
  • Headache and fever[1]

References

  1. ↑ "http://www.bgs.org.uk/Word%20Downloads/delirium.doc". External link in |title= (help)

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Delirium_other_diagnostic_studies&oldid=943695"