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Delirium

Delirium is a sudden, fluctuating disturbance of attention and thinking caused by a physical problem, medicine or intoxication. It is not normal ageing and needs medical assessment the same day; sometimes immediate lifesaving help is needed.

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  • Delirium is an acute disturbance of brain function with altered attention, thinking and level of alertness.
  • It usually begins over hours to days and symptoms often fluctuate; a calm moment does not rule out delirium.
  • Hyperactive delirium causes agitation, hypoactive delirium mainly causes drowsiness and withdrawal, and a mixed pattern alternates between them.
  • Delirium has one or, more often, several physical or substance-related causes that need to be identified promptly.
  • Older people and those with dementia, serious illness, sensory impairment or frailty are at greater risk.
  • Calm reminders about the surroundings, sleep, mobility, enough fluids and aids are important, but do not replace medical treatment of the cause.
  • Delirium may delay recovery and sometimes has lasting effects. Follow-up and assessment of functioning are needed.

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Further reading

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D
Delirium in childrenDelirium in a child is an acute, fluctuating change in attention, consciousness and behaviour caused by illness, treatment, medicine or intoxication. A child may become quiet or agitated, and the underlying cause always needs prompt medical assessment.
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PsychosisDuring psychosis, the ability to judge reality is temporarily severely disrupted, for example by delusions, hallucinations or confused thinking. Early, calm help often improves recovery; danger, severe self-neglect, intoxication or physical instability require urgent assessment.
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Sudden hearing lossSudden hearing loss in one or both ears can result from earwax or middle ear problems, but also acute damage to the inner ear or hearing nerve. Unexplained sudden sensorineural hearing loss needs medical and ENT assessment the same day; early steroids may be appropriate.