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Harrison's Principles of Internal Medicine, 18e
| Part 2. Cardinal Manifestations and Presentation of Diseases > Section 3. Nervous System Dysfunction > |
Chapter 25. Confusion and Delirium
Sections: Confusion and Delirium: Introduction, Acknowledgment, Further Readings.
Topics Discussed: confusion; delirium.
Excerpt:"Confusion, a mental and behavioral state of reduced comprehension, coherence, and capacity to reason, is one of the most common problems encountered in medicine, accounting for a large number of emergency department visits, hospital admissions, and inpatient consultations. Delirium, a term used to describe an acute confusional state, remains a major cause of morbidity and mortality rates, costing billions of dollars yearly in health care costs in the United States alone. Delirium often goes unrecognized despite clear evidence that it is usually the cognitive manifestation of serious underlying medical or neurologic illness.A multitude of terms are used to describe delirium, including encephalopathy, acute brain failure, acute confusional state, and postoperative or intensive care unit (ICU) psychosis. Delirium has many clinical manifestations, but essentially it is defined as a relatively acute decline in cognition that fluctuates over hours or days. The hallmark of delirium is a deficit of attention, although all cognitive domains—including memory, executive function, visuospatial tasks, and language—are variably involved. Associated symptoms may include altered sleep-wake cycles, perceptual disturbances such as hallucinations..."
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