Delirium causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Pratik Bahekar, MBBS [2]; Vishal Khurana, M.B.B.S., M.D. [3];Vindhya BellamKonda, M.B.B.S [4]
Overview
Delirium may be caused by severe physical or mental illness, or any process which interferes with the normal metabolism or function of the brain such as fever, pain, poison (toxic drug reactions), brain injury, surgery, traumatic shock, severe lack of food or water or sleep, and even withdrawal symptoms of certain drug and alcohol dependent states. In addition, there is an interaction between acute and chronic symptoms of brain dysfunction. Delirious states are more easily produced in people already suffering from underlying chronic brain dysfunction. A very common cause of delirium in elderly people is a urinary tract infection, which is easily treatable with antibiotics. Delirium, like mental confusion, is a very general and nonspecific symptom of organ dysfunction. In addition to many organic causes relating to a structural defect or a metabolic problem in the brain, there are also some psychiatric causes, which may also include a component of mental or emotional stress, mental disease.
Life Threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.[1][2]
- Acute liver failure
- Acute Metabolic (acidosis, alkalosis, renal failure, electrolyte imbalances)
- Acute vascular disorder (Stroke, MI, pulmonary embolism, heart failure)
- Adrenal cortex insufficiency
- Acute Altitude sickness
- Brain infection
- Decompression sickness
- Gangrene
- Head injury
- Hyperosmolar non-ketotic diabetic coma
- Hyperthermia
- Hypoglycemia
- Hypothermia
- Hypoxia
- Hypoxemia
- Raised intracranial pressure
- Rickettsiae
- Sepsis
- Toxins/drugs
- Withdrawal
List of Commonly Prescribed Medicines Attributing to Delirium
- Antiarrhythmic
- Antihistamine
- Antiparkinsonian drugs such as benzatropine
- Antispasmodic
- Benzodiazepine
- Diuretic e.g. Furosemide
- Incontinence medicines e.g. Oxybutynin
- Opioid Analgesics
- Tricyclic antidepressant.[3]
Common Causes of Delirium
- Infections (Pneumonia, Urinary Tract Infections)
- Recreational drug use,Drugs popularly used for recreation|Withdrawal]] (ethanol, opiate)
- Acute Metabolic disroder (acidosis, alkalosis, renal failure, electrolyte imbalances)
- Trauma (acute severe pain)
- Central nervous system pathology (epilepsy, cerebral hemorrhage)
- Hypoxia
- Vitamin Deficiencies (vitamin B12, thiamine)[4]
- Endocriopathies
- Acute vascular disease (Stroke, MI, pulmonary embolism, heart failure)
- Heavy metals
- Recreational drug use[5]
Causes by Organ System
Causes in Alphabetical Order
- Acute altitude sickness
- Acute intermittent porphyria
- Acute liver failure
- Acute renal failure
- Adrenal cortex insufficiency
- Alcohol withdrawal
- Antihistamines
- Antipsychotics
- Brain abscess
- Brain infection
- Brain or epidural abscess
- Brain tumor
- Burns
- Cabergoline
- Carbon monoxide toxicity
- Carbon tetrachloride
- Cardiac failure
- Cerebral infarction
- Cerebral malaria
- Cerebral oedema
- Cerebrovascular accident
- Chest infection
- Chronic Liver failure
- Chronic renal failure
- Coproporphyria, hereditary
- Cushing syndrome
- Cyanide
- Daphne poisoning
- Decompression sickness
- Diabetic hypoglycemia
- Diabetic ketoacidosis
- Drug overdose
- Drug withdrawal
- Electric shock
- Elevated or depressed adrenal function
- Elevated or depressed pancreas function
- Elevated or depressed pituitary function
- Encephalitis
- Encephalitis
- Epidural haemorrhage
- Epileptic seizures
- Ethanol
- Ethylene glycol
- Fat embolism
- Folate deficiency
- Gangrene
- Hallucinogens
- Head injury
- Heart failure
- Heat stroke
- Heroin
- Hperthyroidism
- Hpherphosphatemia
- Hydrogen sulfide
- Hyomagnesemia
- Hyperbaric sickness
- Hypercalcemia
- Hypercarbia
- Hypereosinophilia
- Hyperglycemia
- Hypermagnesia
- Hypernatremia
- Hyperosmolar non-ketotic diabetic coma
- Hyperosmolar states
- Hypertensive encephalopathy
- Hyperthermia
- Hyperthyroid
- Hypocalcemia
- Hypoglycemia
- Hyponatremia
- hypoosmolar states
- Hypophosphatemia
- Hypopituitarism
- Hypothermia
- Hypothyroidism
- Hypoxemia
- Hypoxia
- Infections
- Intracranial abscess / granuloma
- Intracranial bleeding
- Intraspinal abscess / granuloma
- Jimson weed
- Lead
- Leukemic blast cell crisis
- Lithium
- Liver failure
- Malaria
- Malignant hypertension
- Marijuana
- Meningitis
- Meningoencephalitis
- Methanol
- Monomethylhydrazine
- Muscle relaxant
- Neurocysticercosis
- Niacin deficiencies
- Nickel poisoning
- Nonconvulsive status epilepticus
- Organic solvent
- Phaeochromocytoma
- Phencyclidine
- Pituitary apoplexy
- Plague
- Poison hemlock
- Polycythemia
- Porphyria
- Postictal state
- Postoperative stress
- Pyelonephritis
- Quinolones
- Rabies
- Raised intracranial pressure
- Renal failure, acute
- Renal failure, chronic
- Respiratory failure
- Rickettsiae
- Schizoaffective disorder
- Sepsis
- Serotonin syndrome
- Skull fracture
- Sleeping sickness (East African)
- Sleeping sickness (West African)
- Subdural empyema
- Surgical wound infection
- Systemic infection
- systemic inflammatory response syndrome
- Systemic organ failure
- Texas Mescalbean poisoning
- Thallium Sulfate poisoning
- Thiamine (Vitamin B1) deficiency
- Thrombocytosis
- Toluene
- Trauma
- Typhoid fever
- Urinary tract infection
- Valproic acid
- Vancomycin resistant enterococcal bacteremia
- Vasculitis
- Venous sinus thrombosis
- Viral hemorrhagic fever
- Vitamin B12 deficiency
- Water hemlock poisoning
- Wernicke's encephalopathy
- Wilson's disease
- Withdrawal states e.g. ethanol, benzodiazepines
- Zanamivir
References
- ↑ Farah, Julia de Lima; Lauand, Carolina Villar; Chequi, Lucas; Fortunato, Enrico; Pasqualino, Felipe; Bignotto, Luis Henrique; Batista, Rafael Loch; Aprahamian, Ivan (2015). "Severe Psychotic Disorder as the Main Manifestation of Adrenal Insufficiency". Case Reports in Psychiatry. 2015: 1–4. doi:10.1155/2015/512430. ISSN 2090-682X.
- ↑ Clegg, A.; Young, J. B. (2010). "Which medications to avoid in people at risk of delirium: a systematic review". Age and Ageing. 40 (1): 23–29. doi:10.1093/ageing/afq140. ISSN 0002-0729.
- ↑ Alagiakrishnan, K (2004). "An approach to drug induced delirium in the elderly". Postgraduate Medical Journal. 80 (945): 388–393. doi:10.1136/pgmj.2003.017236. ISSN 0032-5473.
- ↑ Mavrommati, K; Sentissi, O (2013). "Delirium as a result of vitamin B12 deficiency in a vegetarian female patient". European Journal of Clinical Nutrition. 67 (9): 996–997. doi:10.1038/ejcn.2013.128. ISSN 0954-3007.
- ↑ Markowitz JD, Narasimhan M (October 2008). "Delirium and antipsychotics: a systematic review of epidemiology and somatic treatment options". Psychiatry (Edgmont). 5 (10): 29–36. PMC 2695757. PMID 19724721.