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24 - Delirium and confusional state in stroke patients

Published online by Cambridge University Press:  10 October 2009

By
Hilde Henon  and
Didier Leys
Edited by
Olivier Godefroy  and
Julien Bogousslavsky
Hilde Henon
Affiliation:
University Hospital of Lille, France
Didier Leys
Affiliation:
University Hospital of Lille, France
Olivier Godefroy
Affiliation:
Université de Picardie Jules Verne, Amiens
Julien Bogousslavsky
Affiliation:
Université de Lausanne, Switzerland
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Summary

Main characteristics of delirium and confusional state

Delirium or acute confusional state (ACS) is a mental disorder characterized by acute onset, altered level of consciousness, fluctuating course, and disturbances in orientation, memory, thought, and behavior (Lipowski, 1990). This condition is frequent in stroke patients, although stroke is a rare cause of ACS. Many predisposing factors have been identified. Stroke per se may, however, induce ACS. The occurrence of this behavioral disturbance adversely influences outcome in stroke patients. However, no specific treatment is available.

ACS is an acute, transient disorder of consciousness and cognition with fluctuating intensity. The symptoms of delirium are wide ranging, and although they are non-specific, their abrupt or rapid onset and their fluctuating nature is highly characteristic and is a valuable diagnostic tool. The main feature of delirium is disordered attention with difficulties in focusing and sustaining attention on one stimulus and difficulties in shifting attention to new external stimuli: attention wanders, perseverations may be observed. Attention disturbances are not isolated and examination will reveal abnormalities of thinking, perception, and memory. The change in cognition includes impaired memory, language (anomia, incoherent speech, aphasia, agraphia), disorientation to time and place and visuospatial dysfunction. Perception disturbances may also be present with illusions, hallucinations, or delusions. Sleep–wake abnormalities are frequent with daytime sleepiness and reduced and fragmented sleep during the night with nocturnal agitation, shouting, and aggressivity. Many individuals are restless and hyperactive while others are lethargic.

Type
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Information
The Behavioral and Cognitive Neurology of Stroke , pp. 489 - 509
Publisher: Cambridge University Press
Print publication year: 2007

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Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

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Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

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