Delirium or acute cerebral syndrome
Delirium or acute brain syndrome or psychosis is a sudden state of severe confusion and rapid changes in the brain, which is sometimes accompanied by hallucinations and excessive physical activity, and the patient is not in a normal state. From the point of view of psychology, we can say that delirium is a type of mental disorder that may occur for a few hours during the day in the affected person, causing a disturbance in the person’s concentration and leading to his confusion.
In this disease, a disturbance in alertness and a change in a person’s cognition occurs and spreads within a short period of time. Disturbance in mood, perception and behavior also occurs within a few hours or days and fluctuates, and after the cause is removed, it is quickly resolved.
Symptoms of delirium
Memory impairment
Inability to focus on specific subjects
Inability to answer questions and make decisions
distraction
Failure to react properly to environmental events
Decreased alertness and lack of awareness of time and place
delirium
Predisposing symptoms of delirium
old age
male sex
Cognitive impairment/dementia
Physical illness (cancer, cerebrovascular disease)
Psychiatric comorbidity (eg, depression)
Sensory deprivation (vision loss, hearing loss)
Movement problem
Dehydration/malnutrition
Surgery and injection of anesthetic drugs
Quitting severe alcohol and drug addiction
Stroke or diseases such as dementia and Alzheimer’s
Severe asthma and lack of oxygen to the brain
Brain damage due to excessive or incorrect use of chemical drugs
Taking some sedatives, painkillers, blood pressure and sleeping pills
Intensification and persistence of infection in the body
Cause of delirium
Toxic brain damage (encephalopathy).
Due to exogenous toxins such as alcohol or endogenous toxins such as increased urea in the body
Metabolic brain injury
Hyperthyroidism, reduction of electrolytes such as potassium and reduction of some vitamins such as B2
Infectious brain injury
Diseases such as encephalitis and typhoid
Traumatic brain apple
Any factor that causes trauma to the brain, such as concussion or lightning
Hypoxic brain injury
Any kind of disease and injury that reduces oxygen to the brain.
AIDS
Types of delirium
Hyperactive delirium
In hyperactive delirium, the person usually has symptoms such as restlessness, rapid mood changes, confusion, refusal to engage with others, and hallucinations. People with this type of delirium may react more to events and their surroundings, but these reactions are usually inappropriate and sometimes even threatening. They may be overly emotional or violent and hurt others. These people may also have anxious feelings and tend to escape and resist in contact with their surroundings.
Hypoactive delirium
In hypoactive delirium, a person usually has symptoms such as drowsiness and confusion, desire to sleep, immobility and reduced activity. These people may react less to the events and the environment around them and sometimes even feel apathetic and indifferent to their surroundings. They usually interact less with others and in some cases may become completely self-absorbed and isolated from communication with their surroundings.
Delirium tremens
Alcoholic delirium or alcohol delirium occurs for people who have had a severe addiction to alcohol or drugs for a long time and are trying to quit. Symptoms of this type of delirium may include extreme anxiety, fear, changes in mental status, and even specific hallucinations such as hand and leg tremors. These people usually need immediate medical care and treatment to avoid serious consequences such as hypotension and even electrolyte shock.
Mixed delirium
Delirium is a combination of hyperactive and hypoactive delirium, and a person may have some symptoms of both during the day. This type of delirium usually faces more challenges in diagnosis and management, because different symptoms are seen in these people, which requires a different treatment approach.
Diagnosis of delirium
Blood tests to diagnose delirium
This test involves checking the levels of various chemicals in the blood that can indicate changes in blood pressure, electrolyte levels, ammonia, inflammatory markers, and other signs of underlying diseases that may be associated with delirium. This test can help the doctor to identify the cause of delirium and choose the right treatment plan.
Head scan to diagnose delirium
A head scan, including a CT scan or MRI, can help the doctor detect any structural changes, tumors, bleeding, or blockages in the brain that may be causing deliriom symptoms. These scans may indicate brain damage or complications from other illnesses, such as a stroke, that may be the cause of delirium.
Thyroid test
This test involves checking the levels of thyroid hormones in the blood. Disturbances in the levels of these hormones may cause cognitive and psychological disorders that may be associated with depression. Examining these levels can help the doctor identify the cause of thyroid disorders and apply the appropriate treatment.
Liver test
Liver tests include checking liver function and the levels of various chemicals in the blood. Reviewing this test can help identify complications from poisoning or liver disorders that may accompany delirium.
Chest X-ray
A chest radiograph may be useful in assessing respiratory status and diagnosing respiratory complications associated with delirium, especially in cases where respiratory infections are the cause of delirium. This test can help the doctor identify symptoms caused by respiratory infections such as pneumonia or other respiratory problems and apply the appropriate treatment.
Treatment of delirium
The treatment of delirium includes two main strategies: