Symptoms:

Delirium involves a quick change between mental states (for example, from lethargy to agitation and back to lethargy).

Symptoms include:

• Changes in alertness (usually more alert in the morning, less alert at night)
• Changes in feeling (sensation) and perception
• Changes in level of consciousness or awareness
• Changes in movement (for example, may be slow moving or hyperactive)
• Changes in sleep patterns, drowsiness
• Confusion (disorientation) about time or place
• Decrease in short-term memory and recall
  • Unable to remember events since delirium began (anterograde amnesia)
  • Unable to remember events before delirium (retrograde amnesia)
• Disrupted or wandering attention
  • Inability to think or behave with purpose
  • Problems concentrating
• Disorganized thinking
  • Speech that doesn't make sense (incoherent)
  • Inability to stop speech patterns or behaviors
• Emotional or personality changes
  • Anger
  • Agitation
  • Anxiety
  • Apathy
  • Depression
  • Euphoria
  • Irritability
• Incontinence
• Movements triggered by changes in the nervous system (psychomotor restlessness)

Signs and tests:

The following tests may have abnormal results:

• An exam of the nervous system (neurologic examination), including tests of feeling (sensation), thinking (cognitive function), and motor function
• Neuropsychological studies

The following tests may also be done:

• Ammonia levels in the blood
• Blood chemistry (comprehensive metabolic panel)
• Blood gas analysis
• Chest x-ray
• Cerebrospinal fluid (CSF) analysis
• Creatine kinase level in blood
• Drug, alcohol levels (toxicology screen)
• Electroencephalogram (EEG)
• Head CT scan
• Head MRI scan
• Liver function tests
• Mental status test
• Serum magnesium
• Thyroid function tests
• Urinalysis
• Vitamin B1 and B12 levels