Delirium: A Case Study

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Delirium is a subacute fluctuating disturbance of consciousness characterized by disorientation, inattention, disordered thinking, cognitive impairment, emotional lability, hallucinations or delusions, and sleep-wake cycle disturbance (DynaMed, 2016). Delirium can occur in patients of all ages, but the highest incidence is seen in older patients 65 years and above (DynaMed, 2016). Delirium can be recognized by five key elements namely:
(1) Disturbance in attention and awareness;
(2) Develops over a short period of time and tends to fluctuate during the day;
(3) Additional disturbance in memory deficit, disorientation, language, or perception;
(4) One and three are not better explained by another pre-existing neurocognitive disorder, and
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Delirium often resolves within hours to days, and if delirium does not resolve, the patient should be reevaluated for other underlying causes and assessed for possible dementia (DynaMed, 2016). Delirium more commonly presents as a sudden onset (e.g. hours to days), with an altered level of consciousness and a clouded sensorium. On the other hand, neurodegenerative disorders are associated with dementia and commonly presents gradually with an unimpaired level of consciousness (Chisholm-Burns et al. 2013). It is worthy to note that neurodegenerative disorders once acquired are permanent and relentlessly progressive (Gabbard, …show more content…
Nonpharmacological intervention includes counselling the family on the course and prognosis of illness and pharmacological intervention include management with cholinesterase inhibitor and the NMDA antagonist – Donepezil, rivastigmine, and galantamine (Chisholm-Burns et al. 2013).
Frontotemporal neurocognitive disorder (FTNCD) represents as a spectrum of neurocognitive diseases that compromise function of the frontal brain networks resulting in cognitive and behavioral deficits. FTNCD is a common cause of dementia among patients’ ages 45 – 65 years. This group of neurodegenerative conditions is characterized by progressive and relatively selective atrophy of frontal lobes, temporal lobes, or both, and deterioration in behavior and personality or in language abilities culminating in dementia (DynaMed, 2016).
Vascular neurocognitive disease (VND) This spectrum of cognitive impairments is associated with cerebrovascular disease, ranging from mild cognitive deficits to frank dementia. The causes include heterogeneous group of cerebrovascular diseases and pathologies including brain infarcts, white matter lesions, cerebral hemorrhage, atherosclerosis, small vessel disease, cerebral amyloid angiopathy, and genetic disorders. The clinical and neuropathological features of vascular cognitive impairment often coexist with those of Alzheimer disease (DynaMed,

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