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Semin Neurol 2021; 41(05): 572-587
DOI: 10.1055/s-0041-1733791
Review Article

Evaluation and Management of Delirium

Sophia L. Ryan
1   Department of Neurology, Mount Sinai Medical Center, New York, New York
,
Eyal Y. Kimchi
2   Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
› Author Affiliations
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Abstract

Delirium, sometimes referred to as encephalopathy, is an acute confusional state that is both common in hospitalized patients and associated with poor outcomes. For patients, families, and caregivers, delirium can be a traumatic experience. While delirium is one of the most common diagnoses encountered by the consulting neurologist, the majority of the time it will have been previously unrecognized as such by the care team. Neurologic syndromes such as dementia or aphasia can either be misdiagnosed as delirium or may coexist with it, necessitating careful neurologic assessment. Once the diagnosis of delirium has been established, a careful evaluation for predisposing and precipitating factors can help uncover modifiable contributors, which should be addressed as part of a multicomponent, primarily nonpharmacologic intervention. Importantly, delirium management, which begins with comprehensive prevention, should emphasize the humanity of the delirious patient and the challenges of caring for this vulnerable population. When considered, delirium represents an important opportunity for the neurologist to substantially enhance patient care.

Keywords

delirium - encephalopathy - consultation - agitation


Publication History

Article published online:
07 October 2021

© 2021. Thieme. All rights reserved.

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