neurologic disorders
Delirium
Symptoms and Signs of Delirium
Delirium is characterized primarily by Difficulty focusing, maintaining, or shifting attention (inattention) Consciousness level fluctuates; patients are disoriented to time and sometimes place or person. They may have hallucinations, delusions, and paranoia. Confusion regarding day-to-day events and daily routines is common, as are changes in personality and affect. Thinking becomes disorganized, and speech is often disordered, with prominent slurring, rapidity, neologisms, aphasic errors, or chaotic patterns. Symptoms of delirium fluctuate over minutes to hours; they may lessen during the day and worsen at night. Other symptoms may include inappropriate behavior, fearfulness, and paranoia. Patients may become irritable, agitated, hyperactive, and hyperalert, or, conversely, they may become quiet, withdrawn, and lethargic. Very old people with delirium tend to become quiet and withdrawn—changes that may be mistaken for depression. Some patients alternate between the two. Usually, patterns of sleeping and eating are grossly distorted. Because of the many cognitive disturbances, insight is poor, and judgment is impaired. Other symptoms and signs depend on the cause. 