what causes acute confusional syndrome

It is a transitory syndrome that occurs frequently in older adults or in people who have alcohol addiction

Older people or those who suffer from some particular conditions –like alcoholism, for example- have episodes of confusion. Periods of time in which they suffer disorientation or certain alterations of consciousness, which are not necessarily attributable to a basic pathology.

In medical literature there is a name for this condition And it is acute confusional syndrome, also know as delirium or delirium tremens. It is a transitory syndrome, which is highly frequent in certain groups of population as mentioned.

The main characteristic of this condition is a clear alteration of consciousness and cognitive abilities, which can alert us and lead to confusion with the onset of dementia or any other neurological pathology.

How does an acute confusional syndrome appear?

There are some symptoms or manifestations that clearly indicate the presence of a disorder of this nature. Knowing them can be useful at the time of the medical consultation, on the part of the patient, and in detecting the condition, part of the specialist.

Altered consciousness: the person suffering from this syndrome is not aware of what is happening, that your symptoms are abnormal. That is why he manifests an evident difficulty in paying attention to his environment and those tasks it tries to perform.

Memory problems: it is common that they appear difficulties in remembering recent events or to recognize people from the closest environment.

Temporal and / or spatial disorientation: these difficulties appear very frequently in patients with acute confusional syndrome. Problems recognizing where they are, how lthey arrived there or the day of the week in which they are are common in this group of people.

Hallucinations: misperceptionsI know that they are interpreted as real by the person, like seeing someone who is not really there, erroneous recognition of certain objects, vision of animals or unreal objects, hearing sounds that are not really taking placee etc.

Delusional ideas: in some cases distorted beliefs appear What are they totally real for the person who suffers them. For example, believing that an event that has not really taken place has occurred, or thinking that other people want to cheat or steal it, distrust others, even their close environment, for fear of this deception.

It is important to note that these disturbances can remain for a considerable time -one day, for example- and can manifest more intensity at some particular moments.

Acute confusional syndrome usually appears in older adults

It is worth mentioning that there is also sleep disturbances that can arise from a acute confusional syndrome, as well as psychomotor or emotional distortions.

Sleep disturbances: cycle problems sleep-wake, such as difficulty sleeping at night, great drowsiness during the day, waking up early, among others.

Psychomotor disorders: the psychomotor agitation, erratic wandering, disorderly behavior, are some of the most frequent distortions that appear in this area.

Emotional disturbances: it is common for patients find it difficult to express their emotions or have a higher sensitivity.

Other central feature of this syndrome is that it has a sharp character, which means that it occurs in a short period of time (in hours or days). That is, it does not have an insidious, progressive onset, but it comes on suddenly.

What can cause an acute confusion syndrome?

The main causes of this alteration can be a disease, the ISubstance intoxication or withdrawal (for example, alcohol) or toxic exposure (eg, side effects of a drug or drug overdose). That’s why I know it is a transitory syndrome, precisely because its causes tend to be. When the alterations extend over time and last longer than expected the patient is likely to have another type of condition, more severe and permanent or progressive.

It is important to note that in the older people promptly, common causes of acute confusional syndrome are some pathologies (for example, urine or respiratory infections), the prolonged hospitalization or the intake of certain drugs.

Alcoholism can be one of the causes of acute confusional syndrome

Alcoholism can be one of the causes of acute confusional syndrome

How to differentiate it from the onset of dementia?

The mentioned symptoms can suggest the similarity of this syndrome with the onset of dementia or with other pathologies at the cognitive level. However, there are some defining points that can help differentiate one condition from the other.


He confusional syndrome is characterized by a sharp, sudden onset. This means that in matter of hours or days the patient manifests all or some of the mentioned symptoms. However, in the dementia case, Its onset is usually progressive, that is, it progresses little by little and all of the manifestations can take years to appear.


Considering the possible causes of confusional syndrome, its duration will tend to be short, as long as the problematic that originates it. Therefore, it is configured as a reversible condition: once the cause has been resolved, the person returns to his usual cognitive and general state. However, the dementia is a progressive neurodegenerative disorder, which worsens over time, and whose duration could last for years.


He confusional syndrome finds its origin in some of the causes mentioned above. In the case of dementia, its cause is at the brain level, in neurotransmitters and, ultimately, to genetic level.


The attention span of the person with confusional syndrome is already altered From the first moment. She is distracted, with great difficulties in maintaining attention and focus in what you’re doing as well as to interact properly with their environment. In the case of dementia, on the contrary, the person initially well connected to her surroundings, while distraction and lack of interaction usually appear later.

Psychomotor restlessness

The restlessness and nervousness are symptoms characteristic of the confusional syndrome, accompanied even by trembling and erratic behaviors (such as walking for no apparent reason, performing actions without an objective, etc.). In the case of dementia, this type of Behaviors are not usually presented in initial stages.


In the initial phases of dementiahallucinations are not common, but rather are characteristics of advanced stages of the disease. In the case of confusional syndrome, they are quite common, especially those of the visual type.

All the mentioned elements can be useful when distinguishing confusional syndrome acute from a more severe disease. However, it is important to highlight the need for consult a health professional in case any of the mentioned symptoms appear, both in oneself and in other people. In this way, the specialist will be able to evaluate the patient and know the origin of his condition, which will help him to face the most appropriate treatment.

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