Confusion
This syndrome is characterized by a
combination of confusion is the clouding of consciousness with temporo-spatial
disorientation and memory impairment.
A dreamlike delirium HALLUCINATIONS
may accompany this delirium and altered general condition.
It demonstrates a brain injury.
It is common among the elderly and
can have many causes:
I - ALCOHOL:
It is the leading cause of
confusional state in France, due to acute intoxication (see ACUTE ALCOHOL),
delirium tremens or confuso-dreamlike episodes due to a withdrawal misbehaving.
It can be:
- Hepatic encephalopathy in
cirrhotic patients (see CIRRHOSIS)
- Hypoglycemia after rapid and heavy
alcohol ingestion,
- Wernicke's syndrome.
II - ADDICTION:
Toxic other than alcohol may be
involved: the COCAINE, the AMPHETAMINES (see these terms), solvents
"sniffer".
Some medications can also be
involved: barbiturates, benzodiazepines, antidepressants or if doses are
exceeded, but also corticosteroids, antiparkisoniens and hypoglycemic.
III - CARBON MONOXIDE POISONING AND
BY THE LEAD
IV - CAUSES ENDOCRINE:
. Diabetes, either by major
hypoglycemia due to treatment or misbehaved food,
. hypo-or hypernatremia (sodium) and
hypercalcemia,
. hyperthyroidism, hepatic encephalopathy
and acute renal failure.
V - CAUSES NEUROLOGICAL:
They can be:
. vascular (subarachnoid hemorrhage,
stroke)
. tumor,
. traumatic (or HEMATOMA EXTRA IN
Dural)
. epileptics.
VI - INFECTIOUS CAUSES:
. typhoid, malaria, meningitis,
encephalitis, or just high fever.
VII - EMOTIONAL IMPACT:
Severe emotional shock can cause
delirium: Mourning undergoes serious accident.
VIII - CAUSES MENTAL:
We can see a delirium in melancholic
states (see MELANCOLIE), chronic delusions, when postpartum depression and
early dementia certain.
TREATMENT
Emergency Hospitalization is
required for specialized service where all necessary additional tests will be performed
to determine the exact cause.
In addition to the clinical
examination will be performed:
- FORMULA BLOOD COUNT,
- A SEDIMENTATION RATE,
- Urea
- Creatinine
- Calcium,
- Glucose,
- Electrolytes,
- Urinalysis,
- Chest X-ray,
- Electrocardiogram,
- Amylase,
- Radio skull
- Scanner
- Examination by nuclear magnetic
resonance.
The patient will be left in a
semi-permanently lit room.
It will prevent unauthorized
restraint.
Caloric intake should be high,
combined with a B vitamin therapy routine.
The administration has NEUROLEPTICS
rapid action on the symptoms.
They are first administered by
injection (chlorpromazine, haloperidol).
Benzodiazepines will be reserved for
delirium tremens.
The prognosis depends on the cause
and the rapid initiation of treatment.
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