Causes of Acute Confusional State (Delirium)

In this article, we will discuss various Causes of Acute Confusional State (Delirium). So, let’s get started.

Causes

CNS disorders

A. Vascular: Cerebral, Subarachnoid, Subdural hemorrhage or Hypertensive encephalopathy

B. Infections: Meningitis, encephalitis, typhoid or malarial encephalopathy.

C. Nutritional/Vitamin deficiency: Thiamine (Wrenickle-Korsakoff syndrome), vitamin B12.

D. Head Injury/trauma

E. Epilepsy (postictal)

F. Degenerative: Multiple sclerosis, Alzheimer’s disease, Neoplastic disorders.

Metabolic

• Hepatic or renal failure
• Postoperative state
• Porphyria
• Fluid and electrolyte disturbance

Endocrinal

• Hypo or hyperglycemia
• Hypo or hyperthyroidism
• Hypopituitarism
• Adrenal crisis (Addison’s disease)

Cardiopulmonary

• Myocardial infarction
• Cardiac arrhythmia
• Congestive heart failure
• Respiratory failure (hypoxia, hypercapnia)
• Shock

Systemic illness

• Substance intoxication or withdrawal
• Systemic infection
• Heat injury (hypo or hyperthermia)

Drugs and toxins

• Drugs of use having anticholinergic properties, narcotics, and benzodiazepines.
• Drugs of abuse, e.g. alcohol intoxication and alcohol withdrawal, opiates, ecstasy, LSD, cocaine, marijuana, etc.
• Poisons, e.g. inhalants, CO (carbon monoxide), ethylene glycol, pesticides