acute confusional state delirium Neurology Physiotherapy

Diagnosis of Acute Confusional State (Delirium)

In this article we will discuss the Diagnosis of Acute Confusional State (Delirium)

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


1. Laboratory investigations: They are done in all cases with delirium:

  • Complete blood counts
  • Routine blood biochemistry e.g. sugar, acetone, electrolytes
  • Liver and kidney function tests
  • ECG and X-ray chest
  • Arterial blood gas analysis

2. Additional tests indicated on suspicion of specific conditions:

  • Urine and blood culture and sensitivity
  • Blood levels of drugs and their estimation in urine
  • Serum folate, Vitamin B12 levels, ammonia
  • HIV testing
  • Urinary porphyrins
  • Test for endocrinological disorders (T3, T4, TSH, LH, FSH, cortisol)
  • EEG: Diffuse slowing of EEG has a good correlation with diagnosis of delirium but absence of EEG abnormalities does not rule out the diagnosis. Fast activity is seen in benzodiazepine and alcohol withdrawal delirium.
  • Imaging e.g. CT scan, MRI etc. for neurological disorders
  • CSF analysis: Lumbar puncture should be attempted only after exclusion of mass lesion on CT and if infected etiology of delirium is suspected.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.