157 results match your criteria Confusional States and Acute Memory Disorders


A review of basic to clinical studies of the association between hyperammonemia, methamphetamine.

Naunyn Schmiedebergs Arch Pharmacol 2022 May 23. Epub 2022 May 23.

Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.

Methamphetamine (METH), an addictive psychostimulant drug, is the second most widely used type of drug all around the world. METH abusers are more likely to develop a psycho-neurological complication. Hyperammonemia (HAM) causes neuropsychiatric illnesses such as mental state changes and episodes of acute encephalopathy. Read More

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Transient Global Amnesia.

Am Fam Physician 2022 01;105(1):50-54

Medical University of South Carolina, Greenwood, SC, USA.

Transient global amnesia (TGA) is a clinical syndrome characterized by anterograde amnesia, mild retrograde amnesia, and confusion up to 24 hours. Most commonly seen in patients older than 50 years, TGA results from the temporary impairment of short-term memory formation. Clinically, patients have time disorientation and often ask repeated questions regarding the day's events. Read More

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January 2022

Repetitive hyperbaric oxygen therapy for paroxysmal sympathetic hyperactivity after acute carbon monoxide poisoning.

Undersea Hyperb Med 2021 Fourth Quarter;48(4):431-441

Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea.

Delayed neuropsychological sequelae (DNS) are relatively common complications of acute carbon monoxide (CO) poisoning, and usually develop within several days to weeks after the initial clinical recovery from acute CO poisoning. DNS can consist of various symptoms such as memory loss, confusion, ataxia, seizures, urinary incontinence, fecal incontinence, emotional lability, disorientation, hallucinations, mutism, cortical blindness, psychosis, parkinsonism, gait disturbances, rigidity, bradykinesia, and other motor disturbances. Paroxysmal sympathetic hyperactivity (PSH) is a potentially life-threatening disease secondary to acute acquired brain injury. Read More

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February 2022

Factors Associated With Physical Therapy Engagement During the Period of Posttraumatic Amnesia.

J Neurol Phys Ther 2022 Jan;46(1):41-49

Monash University, Clayton, Victoria, Australia (C.S., J.P., A.M.); Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, Victoria, Australia (C.S., J.P., A.M.); Epworth Healthcare, Richmond, Victoria, Australia (G.W., M.K.); and University of Melbourne, Parkville, Victoria, Australia (G.W.).

Background And Purpose: Physical therapy is important in the management of traumatic brain injury (TBI) and associated multitrauma. Providing therapy during the posttraumatic amnesia (PTA) phase is challenging, given that hallmark features including confusion, amnesia, agitation, and fatigue may impede the person's ability to engage in and benefit from rehabilitation. To date, there is little empirical evidence to guide the provision of therapy during PTA. Read More

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January 2022

Mixed dementia and hyperactive delirium: a diagnostic challenge.

BMJ Case Rep 2021 May 7;14(5). Epub 2021 May 7.

Department of Acute Medicine, Royal Berkshire NHS Foundation Trust, Reading, UK.

It is well recognised that acute confusion or delirium complicates up to 10% of acute medical admissions. Disorientation in time and place with an impaired short-term memory and conscious level are the hallmarks of an acute confusion. In delirium, disorders of perception may produce restlessness and agitation. Read More

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Glucocorticoids and the Brain after Critical Illness.

Endocrinology 2021 03;162(3)

Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA.

Treatment for critical illness typically focuses on a patient's short-term physical recovery; however, recent work has broadened our understanding of the long-term implications of illness and treatment strategies. In particular, survivors of critical illness have significantly elevated risk of developing lasting cognitive impairment and psychiatric disorders. In this review, we examine the role of endogenous and exogenous glucocorticoids in neuropsychiatric outcomes following critical illness. Read More

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Neuropsychiatric Disorders Due to Limbic Encephalitis: Immunologic Aspect.

Int J Mol Sci 2020 Dec 31;22(1). Epub 2020 Dec 31.

Department of Pediatrics, National Taiwan University Hospital, Taipei 100226, Taiwan.

Limbic encephalitis (LE) is a rare cause of encephalitis presenting as an acute and subacute onset of neuropsychiatric manifestations, particularly with memory deficits and confusion as core features, along with seizure occurrence, movement disorders, or autonomic dysfunctions. LE is caused by neuronal antibodies targeting the cellular surface, synaptic, and intracellular antigens, which alter the synaptic transmission, especially in the limbic area. Immunologic mechanisms involve antibodies, complements, or T-cell-mediated immune responses in different degree according to different autoantibodies. Read More

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December 2020

Assessment and Management of Patients in the Acute Stages of Recovery after Traumatic Brain Injury in Adults: A Worldwide Survey.

J Neurotrauma 2021 04 14;38(8):1060-1067. Epub 2020 Dec 14.

Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.

Most individuals with traumatic brain injury (TBI) experience a period of confusion after emergence from coma, termed post-traumatic amnesia, post-traumatic confusional state, or delirium. Recent guidelines suggest the importance of assessment and consistent management during this phase, but current practice worldwide remains unknown. This survey aimed to elucidate current international practice in assessment and treatment of patients in the acute stages of recovery after TBI. Read More

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Comparing the Westmead Posttraumatic Amnesia Scale, Galveston Orientation and Amnesia Test, and Confusion Assessment Protocol as Measures of Acute Recovery Following Traumatic Brain Injury.

J Head Trauma Rehabil 2021 May-Jun 01;36(3):156-163

Turner Institute for Brain and Mental Health, and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia (Drs Spiteri, Ponsford, and McKay); Epworth Healthcare, Richmond, Victoria, Australia (Drs Spiteri, Ponsford, and McKay); and Epworth Healthcare, Victoria, Australia (Drs Jones and McKay).

Background: The duration of the acute period of recovery following traumatic brain injury (TBI) remains a widely used criterion for injury severity and clinical management. Consensus regarding its most appropriate definition and assessment method has yet to be established.

Objective: The present study compared the trajectory of recovery using 3 measures: the Westmead Post-Traumatic Amnesia Scale (WPTAS), the Galveston Orientation and Amnesia Test (GOAT), and the Confusion Assessment Protocol (CAP). Read More

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October 2021

A 71-year-old man with a rare rhabdoid brain tumour: using a multidisciplinary medical and rehabilitative model of care.

BMJ Case Rep 2020 Jun 11;13(6). Epub 2020 Jun 11.

Physical Medicine & Rehabilitation, Washington University in Saint Louis, Saint Louis, Missouri, USA

Atypical rhabdoid tumours (AT/RTs) of pineal origin are rare in adults with rapid progression and poor prognosis. We present the case of a 71-year-old man with confusion and memory loss who was diagnosed with a pineal AT/RT after genetic analysis. Due to his limited functional capacity and goal to return home with family, a multidisciplinary care approach was essential for coordination of medical management, radiation treatment and acute inpatient rehabilitation. Read More

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Shedding light on the clinical recognition process of transient global amnesia.

Eur J Neurol 2020 10 22;27(10):1821-1824. Epub 2020 Jun 22.

Department of Neurology, Mannheim Center of Translational Neuroscience, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.

Background And Purpose: Diagnostic uncertainty is common in the emergency evaluation of neurological conditions such as acute confusional states, particularly for non-neurologists. We aimed to investigate the clinical recognition process of transient global amnesia (TGA) before arrival at the hospital and in the emergency department (ED).

Methods: In this retrospective observational study, medical records of 365 patients with TGA were analysed concerning mode of arrival, symptoms and suspected diagnosis made by pre-hospital medical care providers and the ED neurologist. Read More

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October 2020

Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic.

Lancet Psychiatry 2020 07 18;7(7):611-627. Epub 2020 May 18.

UCL Institute of Mental Health, University College London, London, UK.

Background: Before the COVID-19 pandemic, coronaviruses caused two noteworthy outbreaks: severe acute respiratory syndrome (SARS), starting in 2002, and Middle East respiratory syndrome (MERS), starting in 2012. We aimed to assess the psychiatric and neuropsychiatric presentations of SARS, MERS, and COVID-19.

Methods: In this systematic review and meta-analysis, MEDLINE, Embase, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature databases (from their inception until March 18, 2020), and medRxiv, bioRxiv, and PsyArXiv (between Jan 1, 2020, and April 10, 2020) were searched by two independent researchers for all English-language studies or preprints reporting data on the psychiatric and neuropsychiatric presentations of individuals with suspected or laboratory-confirmed coronavirus infection (SARS coronavirus, MERS coronavirus, or SARS coronavirus 2). Read More

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Neurovascular and immune mechanisms that regulate postoperative delirium superimposed on dementia.

Alzheimers Dement 2020 05 14;16(5):734-749. Epub 2020 Apr 14.

Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA.

Objective: The present work evaluates the relationship between postoperative immune and neurovascular changes and the pathogenesis of surgery-induced delirium superimposed on dementia.

Background And Rationale: Postoperative delirium is a common complication in many older adults and in patients with dementia including Alzheimer's disease (AD). The course of delirium can be particularly debilitating, while its pathophysiology remains poorly defined. Read More

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Treatment of Delirium in Older Persons: What We Should Not Do!

Int J Mol Sci 2020 Mar 31;21(7). Epub 2020 Mar 31.

Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.

The presentation of common acute diseases in older age is often referred to as "atypical". Frequently, the symptoms are neither single nor tissue related. In most cases, the onset of symptoms and diseases is the expression of a diminished reserve with a failure of the body system and imbalance of brain function. Read More

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Cognitive impairment, clinical symptoms and functional disability in patients emerging from the minimally conscious state.

NeuroRehabilitation 2020 ;46(1):65-74

Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA.

Background: Although emergence from the minimally conscious state (eMCS) is associated with symptoms including disorientation, memory and attention impairment, restlessness, and significant functional disability, the neurobehavioral profile of eMCS has not been empirically characterized.

Objective: Determine degree of cognitive impairment, presence of clinical symptoms and functional disability at time eMCS in patients with traumatic and non-traumatic brain injury (TBI, nTBI).

Methods: Retrospective observational study of 169 adults (median [interquartile range] age: 51 [29, 62] years; male: 116; TBI: 103) who emerged from MCS based on the Coma Recovery Scale-Revised while in an inpatient Disorders of Consciousness program. Read More

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A Metabolic Brain Pattern Associated With Anti-N-Methyl-D-Aspartate Receptor Encephalitis.

Psychosomatics 2020 Jan - Feb;61(1):39-48. Epub 2019 Sep 5.

PET/CT Molecular Imaging Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.

Background: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis causes substantial neurological disability. Autoantibodies causing encephalitis directed against the neuronal cell surface or synapse are of diagnostic importance giving the possibility of successful immunotherapy.

Objective: In this study, we aim to provide supporting evidence that brain 18F-FDG-PET may be helpful in identifying likely patterns of regional brain glucose metabolism. Read More

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January 2021

Acute treatment of psychotic symptoms in a newly diagnosed Lewy body dementia patient with an accelerated titration schedule of rivastigmine and de-escalation of antipsychotics.

BMJ Case Rep 2019 Sep 4;12(9). Epub 2019 Sep 4.

Internal Medicine, Mercy Hospital Iowa City, Iowa City, Iowa, USA.

A 76-year-old man presented with complaints of increased confusion, visual hallucinations and decline in memory. He was admitted to the hospital and started on quetiapine 50 mg daily for symptom management. Shortly after, he was diagnosed with Lewy body dementia and started on rivastigmine, a cholinesterase inhibitor (ChEI), at 1. Read More

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September 2019

Acute postoperative pain exacerbates neuroinflammation and related delirium-like cognitive dysfunction in rats.

J Anesth 2019 06 25;33(3):482-486. Epub 2019 Mar 25.

Department of Anesthesiology and Intensive Care Medicine, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.

The acute neuroinflammatory response to surgery may play a key pathogenic role in postoperative delirium (POD). Here, we investigated the contribution of acute postoperative pain to neuroinflammation and related delirium-like behaviors after surgery in adult and aged rats. Animals were assigned into four groups: control, abdominal surgery, surgery with analgesia using local ropivacaine, and surgery with analgesia using systemic morphine. Read More

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Neuropsychological Characteristics of the Confusional State Following Traumatic Brain Injury.

J Int Neuropsychol Soc 2019 03 25;25(3):302-313. Epub 2019 Jan 25.

1Mental Health & Behavioral Sciences,James A. Haley Veterans' Hospital,Tampa,Florida.

Objectives: Individuals with moderate-severe traumatic brain injury (TBI) experience a transitory state of impaired consciousness and confusion often called posttraumatic confusional state (PTCS). This study examined the neuropsychological profile of PTCS.

Methods: Neuropsychometric profiles of 349 individuals in the TBI Model Systems National Database were examined 4 weeks post-TBI (±2 weeks). Read More

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Restructuring Blank Spaces: The Role of Cognitive-Behavioral Interventions for Two Patients With Post-traumatic Amnesia After Severe Traumatic Brain Injury.

Mil Med 2019 01;184(1-2):e266-e271

Department of Psychiatry, University of Illinois College of Medicine, 912 S. Wood Street, MC 913, Chicago, IL.

Differentiation of symptoms associated with post-traumatic amnesia (PTA) versus post-traumatic stress symptoms (PTSS) following trauma presents many treatment challenges among veterans and active duty service members receiving rehabilitation after traumatic brain injury (TBI). The acute phase of rehabilitation poses difficulties for amnestic individuals that may elicit classic PTA symptoms as well as premorbid PTSS, thereby activating maladaptive cognitions and an increase in agitation and arousal. Historically, explicit learning and memory strategies were considered non-efficacious with amnestic individuals until PTA resolves; therefore, rehabilitation therapies have utilized implicit learning in the initial phases of recovery. Read More

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January 2019

Cognitive/affective factors are associated with children's acute posttraumatic stress following pediatric intensive care.

Psychol Trauma 2019 Jan 7;11(1):55-63. Epub 2018 May 7.

Centre of National Research on Disability and Rehabilitation Medicine (CONROD), The University of Queensland.

This study aimed to explore children's experiences and memories of the pediatric intensive care unit (PICU) and identify the relative importance of premorbid, trauma, and cognitive/affective variables associated with acute posttraumatic stress symptoms (PTSS). Participants were 95 children aged 6-16 years admitted to the PICU and their parents. Children completed questionnaires and an interview assessing PTSS, peritrauma affect, and their memory of the admission 3 weeks following discharge. Read More

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January 2019

Involvement of acute neuroinflammation in postoperative delirium-like cognitive deficits in rats.

J Anesth 2018 08 3;32(4):506-517. Epub 2018 May 3.

Department of Anesthesiology and Intensive Care Medicine, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.

Purpose: The purpose of this study was to investigate the age-, time-, and brain region-dependent postoperative neuroinflammatory trajectory, and its association with neurocognitive outcomes in rats.

Methods: Adult and aged rats were randomly assigned to one of three groups: control, isoflurane anesthesia alone, and isoflurane anesthesia with abdominal surgery. On either postoperative day 2 (early phase) or 7 (late phase), all rats were tested for trace and context fear memory retention after acquisition of trace fear conditioning. Read More

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Anteromedial thalamic infarct: a rare presentation.

BMJ Case Rep 2018 May 2;2018. Epub 2018 May 2.

Department of Neurology, Montefiore Hospital and Medical Center, Bronx, New York, USA.

We report a rare presentation of an anteromedial thalamic infarct in a 50-year-old woman with acute onset left eye ptosis, vertical gaze paresis and confusion. MRI identified an acute left anteromedial thalamic infarct with a severe left P1 stenosis. Thalamic infarcts are associated with marked neurobehavioural disturbances with dominant thalamic lesions causing language deficits, verbal perseveration, memory disturbances, abulia and disorientation. Read More

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Tako-tsubo cardiomyopathy with transient global amnesia and cerebellar embolic stroke triggered by existential fear.

Neurol Neurochir Pol 2018 May - Jun;52(3):394-396. Epub 2018 Jan 6.

Rudolfstiftung, Juchgasse 25, A-1030 Wien, Austria. Electronic address:

Background: Embolic stroke is a complication of Tako-Tsubo-cardiomyopathy (TTC), transient left ventricular dysfunction mimicking myocardial infarction without coronary culprit lesion explaining the whole left ventricular dysfunction. Transient global amnesia (TGA) is characterized by sudden onset of anterograde amnesia without compromise of other neurologic functions.

Case Report: A 57 years old female was admitted because of sudden confusion and loss of her memory after emotional stress. Read More

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Latent class analysis of the multivariate Delirium Index in long-term care settings.

Int Psychogeriatr 2019 01 3;31(1):59-72. Epub 2018 May 3.

St. Mary's Hospital Research Centre,Montreal,Quebec,Canada.

ABSTRACTBackground:A few studies examine the time evolution of delirium in long-term care (LTC) settings. In this work, we analyze the multivariate Delirium Index (DI) time evolution in LTC settings.

Methods: The multivariate DI was measured weekly for six months in seven LTC facilities, located in Montreal and Quebec City. Read More

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January 2019

Long-term sequelae of acute respiratory distress syndrome caused by severe community-acquired pneumonia: Delirium-associated cognitive impairment and post-traumatic stress disorder.

J Int Med Res 2018 Jun 2;46(6):2265-2283. Epub 2018 Apr 2.

3 Department of Anesthesiology and Operative Intensive Care Medicine, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Objective Delirium in critically ill patients is considered a risk factor for various long-term consequences. We evaluated delirium and associated long-term outcomes in patients with acute respiratory distress syndrome with non-H1N1 and H1N1- associated severe community-acquired pneumonia (sCAP) who had been recommended to take antiviral drugs associated with delirious symptoms as adverse effects. Methods Of 64 patients, 42 survivors (H1N1, 15; non-H1N1, 27) were analyzed regarding the relationship between medication and the duration of delirium in the intensive care unit. Read More

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[Accessory symptoms of schizophrenia: E. Bleuler's concept].

Authors:
N Yu Pyatnitskiy

Zh Nevrol Psikhiatr Im S S Korsakova 2017;117(11):114-121

Mental Health Research Center, Moscow, Russia.

The analysis of E. Bleuler's concept of accessory symptoms of schizophrenia: delusions, hallucinations, depersonalization disorders, splitting of the ego, memory disorders, catatonic symptoms and acute syndromes (manic and melancholic states, acute paranoia, twilight states, clouding of consciousness, confusion, fugues and dipsomania) is presented. The relationship of accessory symptoms with primary and secondary schizophrenic symptoms according to the second concept of E. Read More

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November 2018

Sevoflurane preconditioning ameliorates lipopolysaccharide-induced cognitive impairment in mice.

Exp Anim 2018 May 29;67(2):193-200. Epub 2017 Nov 29.

Department of Anesthesiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.

Systemic inflammation induces brain neuronal inflammation, in turn causing acute cognitive disorders. Furthermore, neuronal inflammation is one cause of postoperative cognitive disorder (POCD) and delirium. However, no sufficiently established pharmacological treatment is available for neurocognitive inflammation. Read More

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Wernicke-Korsakoff syndrome complicated by subacute beriberi neuropathy in an alcoholic patient.

Clin Neurol Neurosurg 2018 01 8;164:1-4. Epub 2017 Nov 8.

Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Italy. Electronic address:

Thiamine (vitamin B1) deficiency is a common condition in alcohol abusers, which can lead to damage of both the peripheral and the central nervous systems. Here we describe the case of an alcoholic patient who presented with acute onset of ataxia, severe weakness of the four limbs, and hypoesthesia and dysesthesia of the distal portion of the upper and lower extremities. The clinical picture also included mental confusion and amnesia. Read More

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January 2018