Feature of delirium -

Clinical features of delirium  Delirium has an acute onset and rapid progress. The clinical features of delirium are : - 1. Abnormalities of consciousness: - The most conspicuous feature is a clouding of consciousness which ranges from mild dulling to deep coma. 2. Cognitive impairment: - Confusion or disorientation particularly to me and next to place and occasionally to person. Poor concentration, intention, altered sensorium and disturbances of memory are seen. There is impairment of immediate and recent memory, remote memory is normal. 3. Perceptual anomalies : - Delirium is the most common cause of illusion. Hallucination, particularly visual are common. 4. Emotional disturbances: - Most commonly it is fear, followed by anxiety. Less commonly euphoria, apathy or depression may occur. Mood constantly fluctuates, i.e., labile mood. 5. Language disturbances: - Museum as well as rambling and incoherent speech. 6. Psychomotor disturbances: - Hypo or hyperactivity, agitation. 7. Disorder of sleep: - Sleep-wake rhythm is usually altered. Sleep is fragmented and disturbed by nightmares. Diurnal variation with sedation in the day me and restlessness at night (Sundowning) is common. 8. Autonomic disturbances: - Tachycardia, sweating, tremors. 9. Neurological signs : - Tremor, seizure, choreiform movements. 10. Electroencephalography (EEG) : - The most typical finding is diffuse (generalized) slowing. Low voltage fast activity is seen if the delirium is due to the withdrawal of sedative drugs or alcohol.  All symptoms fluctuate in severity and rapidly with apparently normal periods (lucid intervals) in between.