Delirium in the context of "Delirium tremens"

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⭐ Core Definition: Delirium

Delirium (formerly acute confusional state, an ambiguous term that is now discouraged) is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days. As a syndrome, delirium presents with disturbances in attention, awareness, and higher-order cognition. People with delirium may experience other neuropsychiatric disturbances including changes in psychomotor activity (e.g., hyperactive, hypoactive, or mixed level of activity), disrupted sleep-wake cycle, emotional disturbances, disturbances of consciousness, or altered state of consciousness, as well as perceptual disturbances (e.g., hallucinations and delusions), although these features are not required for diagnosis.

Diagnostically, delirium encompasses both the syndrome of acute confusion and its underlying organic process known as an acute encephalopathy. The cause of delirium may be either a disease process inside the brain or a process outside the brain that nonetheless affects the brain. Delirium may be the result of an underlying medical condition (e.g., infection or hypoxia), side effect of a medication such as diphenhydramine, promethazine, and dicyclomine, substance intoxication (e.g., opioids or hallucinogenic deliriants), substance withdrawal (e.g., alcohol or sedatives), or from multiple factors affecting one's overall health (e.g., malnutrition, pain, etc.). In contrast, the emotional and behavioral features due to primary psychiatric disorders (e.g., as in schizophrenia, bipolar disorder) do not meet the diagnostic criteria for 'delirium'.

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πŸ‘‰ Delirium in the context of Delirium tremens

Delirium tremens (DTs; lit. 'mental disturbance with shaking') is a rapid onset of confusion caused by withdrawal from alcohol. DT typically occurs 48–72 hours after the last use of alcohol and symptoms last 1–8 days. Typical symptoms include nightmares, confusion, disorientation, heavy sweating, elevated heart rate, and elevated blood pressure. Visual, auditory, and tactile hallucinations are also common. DT can be fatal especially without treatment. Occasionally, a very high body temperature or seizures (colloquially known as "rum fits") may result in death. Other causes of death include respiratory failure and cardiac arrhythmias.

Delirium tremens typically occurs only in people with a high intake of alcohol for prolonged periods of time, followed by sharply reduced intake. A similar syndrome may occur with benzodiazepine and barbiturate withdrawal, however the term delirium tremens is reserved for alcohol withdrawal. In a person with delirium tremens, it is important to rule out other associated problems such as electrolyte abnormalities, pancreatitis, and alcoholic hepatitis.

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Delirium in the context of Charles VI of France

Charles VI (3 December 1368 – 21 October 1422), nicknamed the Beloved (French: le Bien-AimΓ©) and in the 19th century, the Mad (French: le Fol or le Fou), was King of France from 1380 until his death in 1422. He is known for his mental illness and psychotic episodes that plagued him throughout his life.

Charles ascended the throne at age 11, his father Charles V leaving behind a favorable military situation, marked by the reconquest of most of the English possessions in France. Charles VI was placed under the regency of his uncles: Philip II, Duke of Burgundy; Louis I, Duke of Anjou; John, Duke of Berry; and Louis II, Duke of Bourbon. He decided in 1388, aged 20, to emancipate himself. In 1392, while leading a military expedition against the Duchy of Brittany, the king had his first attack of delirium, during which he attacked his own men in the forest of Le Mans. A few months later, following the Bal des Ardents (January 1393) where he narrowly escaped death from burning, Charles was again placed under the regency of his uncles, the Dukes of Berry and Burgundy.

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Delirium in the context of Deadly nightshade

Atropa bella-donna, commonly known as deadly nightshade or belladonna, is a toxic perennial herbaceous plant in the nightshade family Solanaceae, which also includes tomatoes, potatoes and eggplant. It is native to Europe and Western Asia, including Turkey, its distribution extending from England in the west to western Ukraine and the Iranian province of Gilan in the east. It is also naturalised or introduced in some parts of Canada, North Africa and the United States.

The foliage and berries are extremely toxic when ingested, containing tropane alkaloids. It can also be harmful to handle and/or touch these plants. These toxins include atropine, scopolamine, and hyoscyamine, which cause delirium and hallucinations, and are also used as pharmaceutical anticholinergics. Tropane alkaloids are of common occurrence not only in the Old World tribes Hyoscyameae (to which the genus Atropa belongs) and Mandragoreae, but also in the New World tribe Datureaeβ€”all of which belong to the subfamily Solanoideae of the plant family Solanaceae.

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Delirium in the context of Unconsciousness

Unconsciousness is a state in which a living individual exhibits a complete, or near-complete, inability to maintain an awareness of self and environment or to respond to any human or environmental stimulus. Unconsciousness may occur as the result of traumatic brain injury, brain hypoxia (inadequate oxygen, possibly due to a brain infarction or cardiac arrest), severe intoxication with drugs that depress the activity of the central nervous system (e.g., alcohol and other hypnotic or sedative drugs), severe fatigue, pain, anaesthesia, and other causes.

Loss of consciousness should not be confused with the notion of the psychoanalytic unconscious, cognitive processes that take place outside awareness (e.g., implicit cognition), and with altered states of consciousness such as sleep, delirium, hypnosis, and other altered states in which the person responds to stimuli, including trance and psychedelic experiences.

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Delirium in the context of Confusion

In psychology, confusion is the quality or emotional state of being bewildered or unclear. The term "acute mental confusion" is often used interchangeably with delirium in the International Statistical Classification of Diseases and Related Health Problems and the Medical Subject Headings publications to describe the pathology. These refer to the loss of orientation, or the ability to place oneself correctly in the world by time, location and personal identity. Mental confusion is sometimes accompanied by disordered consciousness (the loss of linear thinking) and memory loss (the inability to correctly recall previous events or learn new material).

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Delirium in the context of Substance intoxication

Substance intoxication is a transient condition of altered consciousness and behavior associated with recent use of a substance. It is often maladaptive and impairing, but reversible. If the symptoms are severe, the term "substance intoxication delirium" may be used. Slang terms for the state include: getting high (generic), and being stoned, cooked, or fried (usually in reference to cannabis).

Substance intoxication may often accompany a substance use disorder (SUD); if persistent substance-related problems exist, SUD is the preferred diagnosis.

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Delirium in the context of Cognitive dysfunction

Neurocognitive disorders (NCDs), also known as cognitive disorders (CDs), are a category of mental health disorders that primarily affect cognitive abilities including learning, memory, perception, and problem-solving. Neurocognitive disorders include delirium, mild neurocognitive disorders, and major neurocognitive disorder (also known as dementia). They are defined by deficits in cognitive ability that are acquired (as opposed to developmental), typically represent decline, and may have an underlying brain pathology. The DSM-5 defines six key domains of cognitive function: executive function, learning and memory, perceptual-motor function, language, complex attention, and social cognition.

Although Alzheimer's disease accounts for the majority of cases of neurocognitive disorders, there are various medical conditions that affect mental functions such as memory, thinking, and the ability to reason, including frontotemporal degeneration, Huntington's disease, dementia with Lewy bodies, traumatic brain injury (TBI), Parkinson's disease, prion disease, and dementia/neurocognitive issues due to HIV infection. Neurocognitive disorders are diagnosed as mild and major based on the severity of their symptoms. While anxiety disorders, mood disorders, and psychotic disorders can also have an effect on cognitive and memory functions, they are not classified under neurocognitive disorders because loss of cognitive function is not the primary (causal) symptom. Additionally, developmental disorders such as autism typically have a genetic basis and become apparent at birth or early in life as opposed to the acquired nature of neurocognitive disorders.

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