Confusion history and symptoms

Jump to navigation Jump to search

Confusion Microchapters

Home

Patient Information

Overview

Pathophysiology

Causes

Differentiating Confusion from other Symptoms

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Confusion history and symptoms On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Confusion history and symptoms

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Confusion history and symptoms

CDC on Confusion history and symptoms

Confusion history and symptoms in the news

Blogs on Confusion history and symptoms

Directions to Hospitals Treating Confusion

Risk calculators and risk factors for Confusion history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

Overview

Confused patients will not be able to provide a coherent history. Confirming the history with patients caregiver is the key to get good history about the patient. Determining the patients drug history and co morbid conditions is very important. In young patients drug abuse and withdrawal should be evaluated. Few assessment scales are used to identify and diagnose confusion. Confusion Assessment Method , Mini Mental Status Examination, The Neelon and Champagne (NEECHAM) Confusion Scale.

History and symptoms

In case of confusion , goal of the physician is to determine the cause of the condition and identifying the risk factors. As the person will be disoriented the history has to be checked with his family or caregivers.

History regarding certain aspects have to be inquired.

  • Onset of symptom and progression

If its sudden in onset it can be due to stroke or hemorrhage into the brain. If its over minutes to hours it can be due drugs or metabolic causes like hypoglycemia, hypokalemia. If its over hours to days it an be due to some underlying disease like kidney or liver failure or infections. If its gradually progressing over months considering other diagnosis like dementia is essential

  • Any previous episodes

Previous episodes of confusion are important to identify risk factors and determine the prognosis. Repeated episodes can be a clue to underlying structural problem or untreated co morbid conditions or metabolic derangement.

  • Associated symptoms

Fever may suggest any infections, abnormal motor activity suggests seizures or post ictal state. Headache is a very important feature to rule out stroke, meningitis or any other intra cranial lesions. Sever diaphoresis indicates dehydration and metabolic disturbance.

  • Drug history

Changes in recent drug regimen or any other drug usage. Polypharmacy can be a cause or result of confusion in elderly individuals. In young patients any history of illicit drug usage has to be noted. As those drugs can cause confusion and their withdrawal states can manifest the same.

References