Causes of Acute Confusional State (Delirium)

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


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.


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


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


  • 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


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