Overview
Clinical Meaning
Delirium is an acute, fluctuating disturbance in attention and cognition caused by an underlying medical condition.
CNPLE
CNPLE
Delirium is an acute, fluctuating disturbance in attention and cognition caused by an underlying medical condition. The pathophysiology involves a complex interplay of neurotransmitter dysfunction: acetylcholine deficiency (the primary neurotransmitter implicated, explaining why anticholinergic medications are a major risk factor), dopamine excess (explaining the efficacy of low-dose antipsychotics), serotonin and GABA imbalance, and neuroinflammation (elevated IL-6, IL-8, TNF-alpha). The cholinergic deficit theory explains why elderly patients (who have age-related cholinergic decline) are most susceptible. Precipitating factors such as infection, metabolic disturbance, medications, or surgery act on a vulnerable brain (reduced cognitive reserve from aging, dementia, or neurodegeneration). Delirium is classified as hyperactive (agitation, hallucinations), hypoactive (lethargy, withdrawal, reduced responsiveness - often missed), or mixed (fluctuating between both). Hypoactive delirium has the worst prognosis because it is frequently unrecognized.
Unlock full lesson + practice questions
4 more sections with scenarios, priorities, and review drills.
Final rapid review before practice
Next study step
Finish the lesson first, then choose a focused activity to apply what you just reviewed.
Continue studying
Sign in to save progress on this lesson.
Unlock the interactive lesson quiz with a plan that includes this CNPLE pathway. You can still explore topic-filtered questions from the bank hubs below.