U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Delirium

MedGen UID:
41445
Concept ID:
C0011206
Mental or Behavioral Dysfunction
Synonyms: ; ABS - Acute brain syndrome; Acute brain syndrome; Altered consciousness or cognition; Delirious
SNOMED CT: Delirious (419567006); ABS - Acute brain syndrome (2776000); Acute brain syndrome (2776000); Delirium (2776000)
 
HPO: HP:0031258
Monarch Initiative: MONDO:0045057

Definition

A state of sudden and severe confusion. [from HPO]

Conditions with this feature

Wernicke-Korsakoff syndrome
MedGen UID:
83883
Concept ID:
C0349464
Mental or Behavioral Dysfunction
A psychotic syndrome caused by damage to the brain by lack of thiamine (vitamin B1). Signs and symptoms include anterograde and retrograde amnesia, confabulation, apathy, ataxia, and coma.
Cobalamin C disease
MedGen UID:
341256
Concept ID:
C1848561
Disease or Syndrome
Disorders of intracellular cobalamin metabolism have a variable phenotype and age of onset that are influenced by the severity and location within the pathway of the defect. The prototype and best understood phenotype is cblC; it is also the most common of these disorders. The age of initial presentation of cblC spans a wide range: In utero with fetal presentation of nonimmune hydrops, cardiomyopathy, and intrauterine growth restriction. Newborns, who can have microcephaly, poor feeding, and encephalopathy. Infants, who can have poor feeding and slow growth, neurologic abnormality, and, rarely, hemolytic uremic syndrome (HUS). Toddlers, who can have poor growth, progressive microcephaly, cytopenias (including megaloblastic anemia), global developmental delay, encephalopathy, and neurologic signs such as hypotonia and seizures. Adolescents and adults, who can have neuropsychiatric symptoms, progressive cognitive decline, thromboembolic complications, and/or subacute combined degeneration of the spinal cord.
Hereditary sensory neuropathy-deafness-dementia syndrome
MedGen UID:
481515
Concept ID:
C3279885
Disease or Syndrome
DNMT1-related disorder is a degenerative disorder of the central and peripheral nervous systems comprising a phenotypic spectrum that includes hereditary sensory and autonomic neuropathy type 1E (HSAN1E) and autosomal dominant cerebellar ataxia, deafness, and narcolepsy (ADCA-DN). DNMT1 disorder is often characterized by moderate-to-severe sensorineural hearing loss beginning in the teens or early 20s, sensory impairment, sudomotor dysfunction (loss of sweating), and dementia usually beginning in the mid-40s. In some affected individuals, narcolepsy/cataplexy syndrome and ataxia are predominant findings.
Bilateral parasagittal parieto-occipital polymicrogyria
MedGen UID:
862085
Concept ID:
C4013648
Disease or Syndrome
Polymicrogyria is a condition characterized by abnormal development of the brain before birth. The surface of the brain normally has many ridges or folds, called gyri. In people with polymicrogyria, the brain develops too many folds, and the folds are unusually small. The name of this condition literally means too many (poly-) small (micro-) folds (-gyria) in the surface of the brain.\n\nPolymicrogyria can affect part of the brain or the whole brain. When the condition affects one side of the brain, researchers describe it as unilateral. When it affects both sides of the brain, it is described as bilateral. The signs and symptoms associated with polymicrogyria depend on how much of the brain, and which particular brain regions, are affected.\n\nResearchers have identified multiple forms of polymicrogyria. The mildest form is known as unilateral focal polymicrogyria. This form of the condition affects a relatively small area on one side of the brain. It may cause minor neurological problems, such as mild seizures that can be easily controlled with medication. Some people with unilateral focal polymicrogyria do not have any problems associated with the condition.\n\nPolymicrogyria most often occurs as an isolated feature, although it can occur with other brain abnormalities. It is also a feature of several genetic syndromes characterized by intellectual disability and multiple birth defects. These include 22q11.2 deletion syndrome, Adams-Oliver syndrome, Aicardi syndrome, Galloway-Mowat syndrome, Joubert syndrome, and Zellweger spectrum disorder.\n\nBilateral forms of polymicrogyria tend to cause more severe neurological problems. Signs and symptoms of these conditions can include recurrent seizures (epilepsy), delayed development, crossed eyes, problems with speech and swallowing, and muscle weakness or paralysis. The most severe form of the disorder, bilateral generalized polymicrogyria, affects the entire brain. This condition causes severe intellectual disability, problems with movement, and seizures that are difficult or impossible to control with medication.

Professional guidelines

PubMed

Smith HAB, Besunder JB, Betters KA, Johnson PN, Srinivasan V, Stormorken A, Farrington E, Golianu B, Godshall AJ, Acinelli L, Almgren C, Bailey CH, Boyd JM, Cisco MJ, Damian M, deAlmeida ML, Fehr J, Fenton KE, Gilliland F, Grant MJC, Howell J, Ruggles CA, Simone S, Su F, Sullivan JE, Tegtmeyer K, Traube C, Williams S, Berkenbosch JW
Pediatr Crit Care Med 2022 Feb 1;23(2):e74-e110. doi: 10.1097/PCC.0000000000002873. PMID: 35119438
Stollings JL, Kotfis K, Chanques G, Pun BT, Pandharipande PP, Ely EW
Intensive Care Med 2021 Oct;47(10):1089-1103. Epub 2021 Aug 16 doi: 10.1007/s00134-021-06503-1. PMID: 34401939Free PMC Article
Devlin JW, Skrobik Y, Gélinas C, Needham DM, Slooter AJC, Pandharipande PP, Watson PL, Weinhouse GL, Nunnally ME, Rochwerg B, Balas MC, van den Boogaard M, Bosma KJ, Brummel NE, Chanques G, Denehy L, Drouot X, Fraser GL, Harris JE, Joffe AM, Kho ME, Kress JP, Lanphere JA, McKinley S, Neufeld KJ, Pisani MA, Payen JF, Pun BT, Puntillo KA, Riker RR, Robinson BRH, Shehabi Y, Szumita PM, Winkelman C, Centofanti JE, Price C, Nikayin S, Misak CJ, Flood PD, Kiedrowski K, Alhazzani W
Crit Care Med 2018 Sep;46(9):e825-e873. doi: 10.1097/CCM.0000000000003299. PMID: 30113379

Curated

UK NICE Clinical guideline CG103, Delirium: prevention, diagnosis and management in hospital and long-term care

Recent clinical studies

Etiology

Iglseder B, Frühwald T, Jagsch C
Wien Med Wochenschr 2022 Apr;172(5-6):114-121. Epub 2022 Jan 10 doi: 10.1007/s10354-021-00904-z. PMID: 35006521Free PMC Article
Mattison MLP
Ann Intern Med 2020 Oct 6;173(7):ITC49-ITC64. doi: 10.7326/AITC202010060. PMID: 33017552
Vlisides P, Avidan M
F1000Res 2019;8 Epub 2019 May 1 doi: 10.12688/f1000research.16780.1. PMID: 31105934Free PMC Article
Oh ST, Park JY
Korean J Anesthesiol 2019 Feb;72(1):4-12. Epub 2018 Aug 24 doi: 10.4097/kja.d.18.00073.1. PMID: 30139213Free PMC Article
Kotfis K, Marra A, Ely EW
Anaesthesiol Intensive Ther 2018;50(2):160-167. Epub 2018 Jun 8 doi: 10.5603/AIT.a2018.0011. PMID: 29882581

Diagnosis

Keenan CR, Jain S
Med Clin North Am 2022 May;106(3):459-469. Epub 2022 Apr 4 doi: 10.1016/j.mcna.2021.12.003. PMID: 35491066
Kappen PR, Kakar E, Dirven CMF, van der Jagt M, Klimek M, Osse RJ, Vincent APJE
Neurosurg Rev 2022 Feb;45(1):329-341. Epub 2021 Aug 16 doi: 10.1007/s10143-021-01619-w. PMID: 34396454Free PMC Article
Mattison MLP
Ann Intern Med 2020 Oct 6;173(7):ITC49-ITC64. doi: 10.7326/AITC202010060. PMID: 33017552
Hshieh TT, Inouye SK, Oh ES
Clin Geriatr Med 2020 May;36(2):183-199. doi: 10.1016/j.cger.2019.11.001. PMID: 32222295
Hshieh TT, Inouye SK, Oh ES
Psychiatr Clin North Am 2018 Mar;41(1):1-17. Epub 2017 Dec 22 doi: 10.1016/j.psc.2017.10.001. PMID: 29412839

Therapy

Wang E, Belley-Côté EP, Young J, He H, Saud H, D'Aragon F, Um K, Alhazzani W, Piticaru J, Hedden M, Whitlock R, Mazer CD, Kashani HH, Zhang SY, Lucas A, Timmerman N, Nishi C, Jain D, Kugler A, Beaver C, Kloppenburg S, Schulman S, Borges FK, Kavosh M, Wada C, Lin S, Sibilio S, Lauw M, Benz A, Szczeklik W, Mokhtari A, Jacobsohn E, Spence J
Br J Anaesth 2023 Aug;131(2):302-313. Epub 2023 Jan 6 doi: 10.1016/j.bja.2022.12.001. PMID: 36621439
Burry LD, Cheng W, Williamson DR, Adhikari NK, Egerod I, Kanji S, Martin CM, Hutton B, Rose L
Intensive Care Med 2021 Sep;47(9):943-960. Epub 2021 Aug 11 doi: 10.1007/s00134-021-06490-3. PMID: 34379152Free PMC Article
McCann ME, Soriano SG
BMJ 2019 Dec 9;367:l6459. doi: 10.1136/bmj.l6459. PMID: 31818811
Martínez-Velilla N, Casas-Herrero A, Zambom-Ferraresi F, Sáez de Asteasu ML, Lucia A, Galbete A, García-Baztán A, Alonso-Renedo J, González-Glaría B, Gonzalo-Lázaro M, Apezteguía Iráizoz I, Gutiérrez-Valencia M, Rodríguez-Mañas L, Izquierdo M
JAMA Intern Med 2019 Jan 1;179(1):28-36. doi: 10.1001/jamainternmed.2018.4869. PMID: 30419096Free PMC Article
Siddiqi N, Harrison JK, Clegg A, Teale EA, Young J, Taylor J, Simpkins SA
Cochrane Database Syst Rev 2016 Mar 11;3(3):CD005563. doi: 10.1002/14651858.CD005563.pub3. PMID: 26967259Free PMC Article

Prognosis

Lee S, Chen H, Hibino S, Miller D, Healy H, Lee JS, Arendts G, Han JH, Kennedy M, Carpenter CR
J Am Geriatr Soc 2022 Jun;70(6):1838-1849. Epub 2022 Mar 11 doi: 10.1111/jgs.17740. PMID: 35274738Free PMC Article
Kappen PR, Kakar E, Dirven CMF, van der Jagt M, Klimek M, Osse RJ, Vincent APJE
Neurosurg Rev 2022 Feb;45(1):329-341. Epub 2021 Aug 16 doi: 10.1007/s10143-021-01619-w. PMID: 34396454Free PMC Article
Ho MH, Nealon J, Igwe E, Traynor V, Chang HR, Chen KH, Montayre J
Worldviews Evid Based Nurs 2021 Oct;18(5):290-301. Epub 2021 Sep 4 doi: 10.1111/wvn.12536. PMID: 34482593
Burton JK, Craig LE, Yong SQ, Siddiqi N, Teale EA, Woodhouse R, Barugh AJ, Shepherd AM, Brunton A, Freeman SC, Sutton AJ, Quinn TJ
Cochrane Database Syst Rev 2021 Jul 19;7(7):CD013307. doi: 10.1002/14651858.CD013307.pub2. PMID: 34280303Free PMC Article
Vlisides P, Avidan M
F1000Res 2019;8 Epub 2019 May 1 doi: 10.12688/f1000research.16780.1. PMID: 31105934Free PMC Article

Clinical prediction guides

Adams SJ, Sprecher A
Clin Perinatol 2022 Mar;49(1):1-14. Epub 2022 Jan 21 doi: 10.1016/j.clp.2021.11.001. PMID: 35209993
Akpinar RB, Aksoy M, Kant E
Nurs Crit Care 2022 Jul;27(4):537-545. Epub 2022 Jan 12 doi: 10.1111/nicc.12741. PMID: 35021263
Egberts A, Moreno-Gonzalez R, Alan H, Ziere G, Mattace-Raso FUS
J Am Med Dir Assoc 2021 Jan;22(1):65-73.e4. Epub 2020 Jul 20 doi: 10.1016/j.jamda.2020.04.019. PMID: 32703688
Hshieh TT, Yue J, Oh E, Puelle M, Dowal S, Travison T, Inouye SK
JAMA Intern Med 2015 Apr;175(4):512-20. doi: 10.1001/jamainternmed.2014.7779. PMID: 25643002Free PMC Article
Pandharipande PP, Girard TD, Jackson JC, Morandi A, Thompson JL, Pun BT, Brummel NE, Hughes CG, Vasilevskis EE, Shintani AK, Moons KG, Geevarghese SK, Canonico A, Hopkins RO, Bernard GR, Dittus RS, Ely EW; BRAIN-ICU Study Investigators
N Engl J Med 2013 Oct 3;369(14):1306-16. doi: 10.1056/NEJMoa1301372. PMID: 24088092Free PMC Article

Recent systematic reviews

Sosnowski K, Lin F, Chaboyer W, Ranse K, Heffernan A, Mitchell M
Int J Nurs Stud 2023 Feb;138:104410. Epub 2022 Nov 29 doi: 10.1016/j.ijnurstu.2022.104410. PMID: 36577261
Kang J, Cho YS, Lee M, Yun S, Jeong YJ, Won YH, Hong J, Kim S
Aust Crit Care 2023 Jul;36(4):640-649. Epub 2022 Jun 17 doi: 10.1016/j.aucc.2022.04.006. PMID: 35718628
Sadlonova M, Duque L, Smith D, Madva EN, Amonoo HL, Vogelsang J, Staton SC, von Arnim CAF, Huffman JC, Celano CM
Gen Hosp Psychiatry 2022 Nov-Dec;79:60-75. Epub 2022 Oct 21 doi: 10.1016/j.genhosppsych.2022.10.010. PMID: 36375344
Kappen PR, Kakar E, Dirven CMF, van der Jagt M, Klimek M, Osse RJ, Vincent APJE
Neurosurg Rev 2022 Feb;45(1):329-341. Epub 2021 Aug 16 doi: 10.1007/s10143-021-01619-w. PMID: 34396454Free PMC Article
Egberts A, Moreno-Gonzalez R, Alan H, Ziere G, Mattace-Raso FUS
J Am Med Dir Assoc 2021 Jan;22(1):65-73.e4. Epub 2020 Jul 20 doi: 10.1016/j.jamda.2020.04.019. PMID: 32703688

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Curated

    • NICE, 2023
      UK NICE Clinical guideline CG103, Delirium: prevention, diagnosis and management in hospital and long-term care

    Consumer resources

    Recent activity

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...