| Category of disorder | Examples/comment |
|---|---|
| Primary neurologicaldisorders | Head injury Post-ictal state Non-dominant parietal lobe stroke Subdural haematoma Subarachnoid haemorrhage Non-convulsive status epilepticus Raised intracranial pressure |
| Substance intoxication or withdrawal | Alcohol intoxication or withdrawal Wernicke's encephalopathy Intoxication with amphetamine and amphetamine-type drugs, benzodiazepines, cannabis, cocaine, opioids and other psychoactive substances Withdrawal of opioids |
| Adverse effect of drugs | Benzodiazepines, tricyclics, analgesics (including NSAIDs), lithium, high-dose corticosteroids, and drugs for parkinsonism Neuroleptic malignant syndrome (Appendix 69.2) |
| Sepsis | Urinary or respiratory tract infections are the commonest causes. Bacterial meningitis (Chapter 68), infective endocarditis (Chapter 52) and intra-abdominal sepsis (e.g. cholangitis (Chapter 35) should also be considered in the patient with delirium and signs of sepsis. Exclude malaria if there has been recent travel to an endemic region (Chapter 33). |
| Other systemic disorders | Hyperglycaemic states Any organ failure Severe electrolyte disorders Severe endocrine disorders Other metabolic disorders |