ABSTRACT
Delirium is defined as a fluctuating disturbance of consciousness with reduced awareness of the environment that has developed relatively acutely. Additional features are impaired attention and altered cognition.15 The problem is triggered by a variety of medical illnesses, intoxications, withdrawal states or metabolic disorders. The terms ‘delirium’ and ‘confusion’ tend to be used interchangeably to describe the same clinical state. Patients in this situation often show an altered sleep cycle, with the confusion or agitation becoming more apparent at night. Delirium, or an acute confusional state, is relatively uncommon in the young, and is usually then attributable to drug intoxication. The problem is more complex in the elderly. In both groups, however, a systematic approach to assessment is needed if the underlying aetiology is to be discovered.
