Confusion, confusion: what is this, causes, symptoms, diagnostics, treatment, prevention

Confusion; Disorientation; Thinking – unclear; Thoughts – cloudy; Altered mental status – confusion

In medicine, “confusion” describes a state of impaired concentration and memory, which can be associated with many different diseases and conditions, like dementia, brain injury, infection, lack of oxygen, certain mental illnesses and certain medications. Patients with confusion may have difficulty orienting themselves in time and space, find the right words, and memorize new information. Important, that the patient with confusion undergo a comprehensive medical examination to identify and treat the cause of the confusion.

Confusion – General information

Confusion can come quickly or slowly over time, depending on the cause. Often the confusion lasts a short time and disappears. Other times it's permanent and incurable. It may be associated with delirium or dementia.

Confusion is more common in the elderly and often occurs during a hospital stay.

Some people may have strange or unusual behavior or may act aggressively.

Reasons for confusion

Confusion can be caused by various health problems, such as:

• Alcohol or drug intoxication
• Encephaloma
• Traumatic brain injury or head injury ( concussion )
• Fever
• Fluid and electrolyte imbalances
• Illness in the elderly, eg, loss of brain function ( imbecility )
• Illness in a person with an existing neurological disease, like a stroke
• Infection
• Lack of sleep (sleep deprivation)
• Low blood sugar
• Low oxygen (eg, due to chronic lung disease)
• Taking certain medications
• Nutritional deficiencies, especially niacin , thiamine or vitamin B12.
• Convulsions
• Sudden drop in body temperature (gipotermiя)

Home care for confusion

Good way to find out, whether the person has confusion - ask the person for his or her name, age and date of birth. If they are not sure or answer incorrectly, they have confusion.

If the person does not usually have confusion, consult a doctor.

In this case, a person cannot be left alone.. For safety reasons, a person may need someone nearby, to calm him down and protect him from injury.

To help a person with confusion:

• Always introduce yourself, regardless of Togo, how well the person once knew you.
• Frequently remind the person of their location.
• Put the calendar and clock next to the person.
• Tell us about current events and plans for the day.
• Try, to be calm around, quiet and peaceful.

For sudden confusion due to low blood sugar (eg, due to diabetes medication) the person should drink a sweet drink or eat something sweet. If the confusion lasts more 10 minutes, seek medical attention.

When to Seek Medical Help for Confusion

Call the emergency number, if suddenly a person has confusion or other symptoms, such as:

• Cold or clammy skin
• Dizziness or feeling weak
• Rapid pulse
• Fever
• Headache
• Slow or fast breathing
• uncontrollable shivering

Also call emergency services, if:

• Confusion of consciousness in a person arose for the first time
• A person with diabetes has a sudden confusion
• Confusion arose after a head injury
• The person is in danger of harming themselves or others
• Man suddenly loses consciousness

If you are experiencing confusion, contact your doctor, to make an appointment.

What to Expect When Visiting a Doctor for Confusion

The doctor will perform a physical examination and ask questions about confusion. The doctor will ask questions, to identify, does the person remember the date, time and where he or she is. Among other things, questions will be asked about recent and ongoing illnesses.

Tests, which can be ordered, include:

• Blood tests
• Head CT
• Electroencephalogram (EEG)
• Mental Status Tests
• Neuropsychological tests
• Urine

Treatment depends on the cause of the confusion. For Example, if confusion is caused by an infection, infection treatment, probably, eliminate confusion.

Used literature and sources

Ball JW, Dains I, Flynn YES, Solomon BS, Stewart RW. Mental status. In: Ball JW, Dains I, Flynn YES, Solomon BS, Stewart RW, eds. Siedel’s Guide to Physical Examination. 10th ed. St Louis, MO: Elsevier; 2023:chap 7.

Maciel CB, Elie-Turenne M-C. Seizures. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 14.

Mendez MF, Yerstein O. Delirium. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff’s Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022: chap 4.