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Symptoms and Signs – Differential Diagnosis of Delirium (acute confusional state)
Dementia
Drugs: opiates, anticholinergics, anxiolytics, anticonvulsants, corticosteroids, digoxin, dopaminergic agonists, recreational drugs
Epilepsy: status epilepticus, post-ictal states
Hypertensive encephalopathy
Hypoglycaemia
Hypoxia (respiratory/cardiac failure)
Infection: lntracranial (meningitis, encephalitis, abscess, cerebral malaria, neurocysticercosis}, Extracranial: chest infection, urinary infection (esp. elderly}, surgical wounds, IV lines
Inflammation: vasculitis
Metabolic: liver failure, renal failure, electrolyte imbalances (e.g. hyponatraemia, hypercalcaemia}, endocrinopathies, nutritional deficiencies (B 12, nicotinic acid,
thiamine}
Toxic: alcohol (withdrawal, Wernicke's encephalopathy}
Trauma: head injury, subdural haematoma
Tumour: space-occupying lesions
Vascular: intracranial bleeding, infarction, venous sinus thrombosis
Dementia
Drugs: opiates, anticholinergics, anxiolytics, anticonvulsants, corticosteroids, digoxin, dopaminergic agonists, recreational drugs
Epilepsy: status epilepticus, post-ictal states
Hypertensive encephalopathy
Hypoglycaemia
Hypoxia (respiratory/cardiac failure)
Infection: lntracranial (meningitis, encephalitis, abscess, cerebral malaria, neurocysticercosis}, Extracranial: chest infection, urinary infection (esp. elderly}, surgical wounds, IV lines
Inflammation: vasculitis
Metabolic: liver failure, renal failure, electrolyte imbalances (e.g. hyponatraemia, hypercalcaemia}, endocrinopathies, nutritional deficiencies (B 12, nicotinic acid,
thiamine}
Toxic: alcohol (withdrawal, Wernicke's encephalopathy}
Trauma: head injury, subdural haematoma
Tumour: space-occupying lesions
Vascular: intracranial bleeding, infarction, venous sinus thrombosis
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