Delirium differential diagnosis

Delirium vs. dementia (critical distinction). Delirium AKA acute confusional state. Distinct from dementia; however, patients with dementia are at increased risk of developing delirium.

A primary disorder of attention that subsequently affects all other aspects of cognition.

Often represents life-threatening illness, e.g.hypoxia, sepsis, uremic encephalopathy, electrolyte abnormality, drug intoxication, MI. 50% of patients die within 2 yrs of this diagnosis.

Unlike dementia, delirium has an acute onset, motor signs (tremor, myoclonus, asterixis), slurred speech, altered consciousness (hyperalert/agitated or lethargic, or fluctuations), hallucinations may be florid.

EEG shows pronounced diffuse slowing.

Status epilepticus.

see Alcohol withdrawal seizures.