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Confusion

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Neurology

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Abstract

Confusion is among the most common neurological complaints in hospitalized patients. It is characterized principally by the loss of the normal coherent stream of thought or action, and may manifest as agitated delirium or somnolence. Examination of a confused patient should focus on assessment of attention. Fluent aphasias, neglect, transient global amnesia, psychosis, and the Charles Bonnet syndrome are important conditions that may be misdiagnosed as confusion. The right-hemispheric syndrome is a multimodal disorder of directed attention. Toxic-metabolic disturbances are the most common causes of confusion, and encephalopathies related to alcohol and hepatic dysfunction have characteristic presentations. Meningitis and encephalitis are important causes of confusion and can be overlooked if directed evaluation is not performed. Lumbar puncture is an important diagnostic tool in the evaluation of a confused patient, and can be performed easily if anatomic landmarks are identified and proper positioning is achieved. Structural lesions of the brain are uncommon causes of confusion. Most disorders that produce confusion are treatable if recognized in a timely fashion.

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Authors and Affiliations

  1. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Andrew Tarulli

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© 2016 Springer International Publishing Switzerland

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Tarulli, A. (2016). Confusion. In: Neurology. Springer, Cham. https://doi.org/10.1007/978-3-319-29632-6_1

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  • DOI: https://doi.org/10.1007/978-3-319-29632-6_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29630-2

  • Online ISBN: 978-3-319-29632-6

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