Differential diagnosis of agitation and confusion
| Differential diagnosis of agitation and confusion | ||||
| Delirium (acute confusional state) | Emotional reactions | Psychosis | Dementia | |
| Prevalence | Common | Common | Rare as a new presentation in an acute hospital setting | Extremely rare |
| Onset | Acute or subacute | Acute or acute-onchronic | Insidious | |
| Course | Fluctuating, usually resolves over days to weeks | Progressive | ||
| Conscious level | Often impaired, can fluctuate rapidly | Intact | Clear until later stages | |
| Cognitive defects | Poor short-term memory, poor attention span | Absent | Absent | Poor short-term memory, attention less affected until severe |
| Hallucinations | Common, especially visual | None | Auditory; third person | Often absent |
| Delusions | Fleeting, nonsystematized | None | Fixed and systematized | Often absent |
| Psychomotor activity | Increased, reduced or unpredictable | Typically increased | Can be normal | |
Source: Forsyth R, Newton R, eds. Paediatric Neurology (Oxford Specialist Handbooks in Paediatrics). 3 ed. ed. Oxford, UK: Oxford University Press; 2017. https://oxfordmedicine.com/view/10.1093/med/9780198784449.001.0001/med-9780198784449.
Discussion