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Delirium (formerly acute confusional state, an ambiguous term which is now discouraged) [1] is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days.
Terminal lucidity is a narrower term than the phenomenon paradoxical lucidity where return of mental clarity can occur anytime (not just before death). [ 4 ] [ 5 ] However, as of 2024 [update] , terminal lucidity is not considered a medical term and there is no official consensus on the identifying characteristics.
The Confusion Assessment Method (CAM) is a diagnostic tool developed to allow physicians and nurses to identify delirium in the healthcare setting. [1] It was designed to be brief (less than 5 minutes to perform) and based on criteria from the third edition-revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R).
The term clouding of consciousness has always denoted the main pathogenetic feature of delirium since physician Georg Greiner [5] pioneered the term (Verdunkelung des Bewusstseins) in 1817. [6] The Diagnostic and Statistical Manual of Mental Disorders (DSM) has historically used the term in its definition of delirium. [ 7 ]
The term sundowning was coined by nurse Lois K. Evans in 1987 due to the association between the person's increased confusion and the setting of the sun. [2] [3] For people with sundown syndrome, a multitude of behavioral problems begin to occur and are associated with long-term adverse outcomes.
This is usually characterized by an expeditious onset of delirium, mania, psychosis, followed by grandiosity, emotional lability, altered consciousness, hyperthermia, and in extreme cases, death. [1] It is sometimes misdiagnosed as excited delirium (EXD) or catatonia due to the presence of overlapping symptoms.
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia, advanced heart disease, and for HIV/AIDS, or long COVID in bad cases, rather than for injury.
Delirium tremens was also given an alternate medical definition since at least the 1840s, being known as mania a potu, which translates to 'mania from drink'. [28] The Belgian beer "Delirium Tremens," introduced in 1988, is a direct reference and also uses a pink elephant as its logo to highlight one of the symptoms of delirium tremens. [29] [30]