University:
The University of British Columbia
Course:
MEDD 448 | Transition into Postgraduate Education and Practice
Academic year:

2024
Views:

452

Pages:

2
Author:

O. Touhami

‭ onfusion Syndrome: Acute Onset, Reversible Course, and Diverse‬ C ‭Manifestations‬ ‭-‬‭Definition :‬ ‭o‬ ‭Global neuropsychological and behavioral disorganization and moderate decline‬ ‭in‬ ‭ lertness.‬ a ‭ ‬ ‭Acute onset, reversible course (different from‬ o ‭dementia).‬‭Confusion = emergency, acute installation,‬ ‭reversible if treated.‬ ‭‬ E o ‭ mergency.‬ ‭o‬ ‭Multiple causes.‬ ‭-‬‭Positive diagnosis: o‬ ‭Acute installation.‬ ‭o‬ ‭Massive neuropsychological deficits:‬ ‭o‬ ‭Perception: unclear, distorted.‬‭The patients look perplexed as if‬ ‭they cannot see or hear well. Sometimes an impression that they‬ ‭do not perceive at all.‬ ‭o‬ ‭Hyperreactivity irrelevant to inattention.‬‭Example: slamming‬ ‭door causing an exaggerated reaction.‬ ‭o‬ ‭Misperceptions - hallucinations.‬‭Example: pizza on the ceiling, if‬ ‭hallucinations concern animals = zootopia - common in‬ ‭alcohol withdrawal.‬ ‭o‬ ‭Temporo-spatial disorientation.‬‭Found in any cognitive‬ ‭disorder:‬ ‭o‬ ‭Aphasic: for language reasons.‬ ‭o‬ ‭Demented: for reasons of memorization.‬ ‭o‬ ‭Confused: for multiple reasons.‬ ‭o‬ ‭Memory and language problems.‬ ‭‬ B o ‭ ehavior and speech: inappropriate, disorganized, agitation/slowness.‬ ‭Examples:‬ ‭o‬ ‭Wear warm in summer and light in winter. Urine‬ ‭o‬ ‭in the middle of the emergency room.‬ ‭ ‬ ‭Decline in alertness: sleep-wake rhythm, fluctuations, slowing‬ o ‭down, drowsiness, difficulty maintaining activities.‬ ‭o‬ ‭Slowed patients: bradypsychia.‬ ‭o‬ ‭Fluctuations in their disorders: more or less intense‬ ‭disorders from one period of the exam or the day to‬ ‭another. Phase of agitation which alternates with slowing‬ ‭down.‬ ‭ ‬ ‭Inversion of the sleep-wake rhythm - nycthemeral rhythm.‬ o ‭ ‬ ‭Neurovegetative syndromes: hyperthermia, hypertension, tachycardia,‬ o ‭dehydration - serious signs.‬‭Hyperthermia + confusion = possibly‬ ‭meningeal syndrome.‬ ‭-‬‭Differential diagnosis : o‬ ‭Wernicke's aphasia.‬ ‭o‬ ‭Manic attack and acute psychotic attack: perception, vigilance,‬‭crazy‬ ‭theme‬‭, memorization.‬ ‭o‬ ‭Akinetic mutism.‬ ‭-‬‭Etiological diagnosis: o‬ ‭Dominated by toxic and metabolic causes.‬‭Such as alcohol withdrawal.‬‭May‬ ‭o‬ ‭reveal dementia beginning in the elderly.‬‭Any confusion in the elderly‬ ‭without apparent etiology should lead to a search for incipient‬ ‭dementia.‬