Key messages

• Delirium is a syndrome with multiple etiologies comparable with conditions such as heart failure or renal insufficiency.

• Delirium can be conceptualized as an acute and often reversible alteration of consciousness resulting from temporary or permanent damage of cortical and subcortical structures as well as from perturbations of several neurotransmitter systems.

• Many prescription drugs and several illicit drugs cause delirium. Of particular interest are those used commonly in intensive care settings.

• Manic patients or patients with agitated/psychotic depression might present as agitated and confused. Since mood disturbances often coexist with delirium, it is difficult to exclude a primary mood disorder in a delirious patient.

• Seizures, particularly complex partial seizures, can produce a behavioral syndrome that mimics delirium.

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