Delirium (Latin delirium – madness, delirium) – a mental disorder, occurring in violation of consciousness (from the darkened state to coma). It is characterized by the influx of bright, mainly visual, hallucinations and delusions, difficulty in orientation in the world, disorientation in time. In awareness of self is preserved. The emotional state of the patient depends on the nature of hallucinations.
Lindesay (1999) reports that the term “delirium” was introduced by ancient Roman scholar named Aulus Cornelius Celsus in the I century AD..
In the modern interpretation of the term “delirium” has lost its former psychopathological content, as a qualitative disturbance of consciousness with true, mostly visual, hallucinations. Clinic of delirium, according to modern classifications of mental disorders ICD-10 and DSM-IV includes a variety of states for the country’s traditional psychopathology as quality (the actual delirium, amentia, oneiric) and quantitative (stunning, sopor, coma), disorders of consciousness, as well as related these cognitive disorders and other mental functions.
What Causes Delirium
The main causes of delirium and confusion:
1. Therapeutic or surgical illness ( there are no symptoms of foci or lateralization, cerebrospinal fluid is unchanged):
- Postoperative (hypoxia) and postconcussional state.
- Diseases, accompanied by fever pneumonia, typhoid fever, malaria, strep septicemia, rheumatic fever.
- Thyrotoxicosis and the poisoning of ACTH (rare).
2. Neurological diseases, leading to symptoms or lateralization of foci, or changes in the cerebrospinal fluid:
- Vascular, tumor, or traumatic lesions, particularly of the temporal lobes and upper brain stem.
- Acute bacterial or tuberculous meningitis.
- Subarachnoid hemorrhage.
- Viral encephalitis or meningoencephalitis, especially herpes.
3. Abstinence, exogenous intoxication, postictal states (signs of other medical, surgical and neurological diseases are absent or occur by chance):
- Withdrawal alcohol syndrome (delirium tremens), withdrawal syndrome of barbiturates and other sedatives after prolonged use.
- Drug intoxication (fenaminom, camphor, caffeine, ergot alkaloids, scopolamine, atropine, etc.).
- Postictal delirium.
Pathogenesis (what’s going on?) During delirium
Delirium can be viewed as a transient mental disorder, reflecting an acute brain failure due to diffuse errors of metabolism. Delirium as it is a kind of physiological decompensation of brain functions, is similar to the syndrome of heart, kidney or liver failure.
Delirium usually occurs due to disturbances associated with different brain proper and common diseases, as well as it can be influenced by a number of chemicals, hypoxia, sleep deprivation, deprivation of abstinence in drug trafficking. Usually among the causes of delirium there are three main groups:
1) diseases of the central nervous system (ex. epilepsy, meningitis or encephalitis);
2) systemic medical conditions (ex. cardiac, pulmonary, renal or hepatic failure);
3) toxicity (ex. neurotoxins in the common infections, drugs, alcohol, drugs).