Delirium: Complications

The following are the most important diseases or complications that may be contributed to by delirium:

Psyche – Nervous System (F00-F99; G00-G99).

  • Recurrent delirium (recurrent delirium).
  • Cognitive deficits

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Propensity to fall

Further

  • Social restrictions
  • Nursing home admission (seniors; because of postoperative cognitive deficit (POCD) or postoperative delirium)
  • 12-month mortality (death rate) of an intensive care patient is 2.11-fold

Complications of alcohol withdrawal delirium

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Electrolyte disorders:
    • Hypokalemia (potassium deficiency; < 3.5 mmol/l).
    • Hyponatremia (sodium deficiency; < 135 mmol/l)
    • Hypomagnesemia (magnesium deficiency; 1.8 mmol/l)
  • Wernicke’s encephalopathy (synonyms: Wernicke-Korsakow syndrome; Wernicke’s encephalopathy) – degenerative encephaloneuropathic disease of the brain in adulthood; clinical picture: brain-organic psychosyndrome (HOPS) with memory loss, psychosis, confusion, apathy, and gait and stance unsteadiness (cerebellar ataxia) and eye movement disorders / eye muscle paralysis (horizontal nystagmus, anisocoria, diplopia)); vitamin B1 deficiency (thiamine deficiency).

Cardiovascular system (I00-I99).

Psyche – nervous system (F00-F99; G00-G99).

  • Alcohol withdrawal seizures (6-48 h after last use); symptomatology: tonic-clonic-generalized, single or series/status focal seizures.
  • Central pontine myelinolysis (“osmotic demyelination syndrome”); occurrence almost always when hyponatremia (sodium deficiency) is compensated too quickly; symptomatology: Dysarthria (speech disorders), dysphagia (dysphagia), pyramidal tract signs, para/tetraparesis (bilateral incomplete paralysis (paresis) of one pair of extremities/complete paralysis of all four limbs, i.e., arms and legs), clouding of consciousness, locked-in syndrome (locked-in or Trapped-in syndrome) – condition in which a person is conscious but physically almost completely paralyzed and unable to make himself understood by speech or movement.

Injuries, poisoning, and other consequences of external causes (S00-T98).

  • Epidural hematoma (intracranial bleeding (brain hemorrhage) into the space between the skull bones and the dura mater (epidural space)) – bruise marks on the head? Symptomatology: nausea, vomiting, headache, clouding of consciousness, neurological deficits; secondary clouding!
  • Subdural hematoma (SDH) – hematoma (bruise) under the hard meninges between the dura mater (hard meninges) and arachnoid (spider tissue membrane); risk group: patients under anticoagulation (anticoagulation);bruise marks on the head?
    • Acute subdural hematomaSymptoms: Disturbances of consciousness up to unconsciousness.
    • Chronic subdural hematomaSymptoms: uncharacteristic complaints such as a feeling of pressure in the head, cephalgia (headache), vertigo (dizziness), restriction or loss of orientation and ability to concentrate.