In persons with diabetes mellitus (n= 37), we found hypoglycaemia in 11 persons (29.7%) followed by nonhaemorrhagic stroke in 7 persons (18.9%) as the cause of acute confusional state
In these 59 patients, the most frequent neuropsychiatric manifestations were a headache (56%), acute confusional state
(46%), seizure disorder (29%), and cerebrovascular disease (25%).
Different types of psychiatric syndromes have been described and included psychosis, depression, acute confusional state
, anxiety, cognitive dysfunction and mood disorder.
A 50-year-old woman, known to have been recently diagnosed with advanced colonic carcinoma, and on palliative therapy, presented with an acute confusional state
and associated seizures.
His acidosis worsened to a nadir of pH 6.97 and he developed an acute confusional state
with marked agitation for which titrated IV doses of diazepam and haloperidol were administered.
Lesley also co-authored, together with Nages Negaratnam and Gary Cheuk, the article 'Acute confusional state
in patients with and without dementia', in the Archives of Gerontology and Geriatrics 29 (1999) 139-147.
The reported clinical features include generalised convulsions, acute confusional state
, psychosis, tremors, cerebellar ataxia, motor aphasia, and generalised myoclonus (2,3).
Faecal impaction may also cause an acute confusional state
and abdominal pain .
Other manifestations of patients with single ring enhancing CT lesions were hemiplegia (9.61%), headache due to raised intracranial pressure (7.69%), crural monoparesis (7.69%), acute confusional state
(7.69%), Broca's aphasia (5.76%) and Broca's aphasia with upper limb weakness (3.85%).
Major Finding: Following exclusions of non-SLE-related causes of neuropsychiatric problems, glucocorticoids and immunosuppressives are indicated for neuropsychiatric SLE manifestations that reflect an immune or inflammatory process, including acute confusional state
, aseptic meningitis, myelitis, psychosis, and cranial and peripheral neuropathies.
Brain damage associated with dementia also places these patients at risk for delirium or acute confusional state
, further increasing disorientation and confusion.
Delirium is a temporary and acute state of confusion, also referred to as an acute confusional state
. The American Psychiatric Association identifies delirium as a transient organic mental syndrome characterised by a reduced Level of consciousness, reduced ability to focus, perceptual disturbances and memory impairment.