Acute Confusion: Or something else? Differential Diagnosis

Respiratory System (J00-J99)

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

  • Dehydration (lack of fluids) [esp. in old age].
  • Diabetic ketoacidosis – severe metabolic derailment (ketoacidosis) in the absence of insulin) – mainly in diabetes mellitus type 1.
  • Electrolyte disorders (disorders of blood salts), unspecified; e.g.:
    • Hypercalcemia (excess calcium).
    • Hyponatremia (sodium deficiency)
    • Hypernatremia (excess sodium)
  • Hyperparathyroidism (parathyroid hyperfunction).
  • Hyperglycemia (hyperglycemia)
  • Hypoglycemia (hypoglycemia)
  • Hypoparathyroidism (hypothyroidism of the parathyroid gland).
  • Cushing’s disease – group of diseases leading to hypercortisolism (hypercortisolism; excess of cortisol).
  • Myxedema – pasty (puffy; bloated) skin showing non-push-in, doughy edema (swelling) that is not position-dependent; facial and peripheral; occurring primarily on the lower legs
  • Thyrotoxic crisis – acute and life-threatening metabolic derailment; usually on the ground of an existing hyperthyroidism (hyperthyroidism).
  • Wernicke’s encephalopathy (synonyms: Wernicke-Korsakow syndrome; Wernicke’s encephalopathy) – degenerative encephaloneuropathic disease of the brain in adulthood; clinical presentation: 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, double vision (diplopia)); vitamin B1 deficiency (thiamine deficiency).

Cardiovascular system (I00-I99).

  • Apoplexy (stroke)
  • Acute cardiac arrhythmia
  • Hypertensive derailment (blood pressure crisis)
  • Pulmonary embolism – partial (partial) or complete obstruction of a pulmonary artery, mainly due to pelvic-leg thrombosis (about 90% of cases).
  • Transient ischemic attack (TIA) – sudden circulatory disturbance of the brain, leading to neurological disorders that regress within 24 hours.

Infectious and parasitic diseases (A00-B99).

  • Infections of the brain, unspecified; here in particular: septic encephalopathy (pathological changes of the brain), herpes encephalitis.
  • Systemic infection, unspecified

Liver, gallbladder, and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).

Neoplasms – tumor diseases (C00-D48).

  • Brain tumor, unspecified

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

  • Alcohol withdrawal
  • Alcohol intoxication (alcohol poisoning)
  • Dementia (global mental impairment).
  • Drug withdrawal
  • Drug intoxication (drug poisoning), unspecified
  • Hepatic encephalopathy
  • Postictal state – state following an epileptic seizure.
  • Transient global amnesia (TGA) – acute onset disorder of all memory functions.

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

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).

  • Acute renal failure (ANV)

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

  • Carbon monoxide poisoning

Medication

Operations

Environmental pollution – Intoxications (poisoning).

  • Intoxications, e.g.:
    • Alkaloids
    • Alcohol
    • Hypnotics (sleeping pills)
    • Carbon monoxide
    • Hydrocarbons (aliphatic, aromatic)
    • Opiates (painkillers such as morphine)
    • Sedatives (tranquilizers)
    • Hydrogen cyanide/potassium cyanide