Jump to content

User:Mr. Ibrahem/Excited delirium

From Wikipedia, the free encyclopedia
Mr. Ibrahem/Excited delirium
Other namesExcited delirium syndrome, agitated delirium
An example of physical restraints which may be used until chemical sedation takes effect.
SpecialtyEmergency medicine, psychiatry
SymptomsAgitation, delirium, sweating[1]
ComplicationsRhabdomyolysis, high blood potassium[1]
CausesDrug use, mental illness[1]
Differential diagnosisLow blood sugar, heat stroke, thyrotoxicosis, paranoid schizophrenia, bipolar disorder[1]
TreatmentSedation, cooling, intravenous fluids[1]
MedicationKetamine or midazolam and haloperidol[2]
PrognosisRisk of death < 10%[1]
FrequencyUnknown[1]

Excited delirium, also known as agitated delirium, is a condition that presents with psychomotor agitation, delirium, and sweating.[1] It may include attempts at violence, unexpected strength, and very high body temperature.[3] Complications may include muscle breakdown or high blood potassium.[1]

The cause is often related to long term drug use or mental illness.[1] Commonly involved drugs include cocaine, methamphetamine, or certain substituted cathinones.[3] In those with mental illness, rapidly stopping medications such as antipsychotics may trigger the condition.[1] The underlying mechanism is believed to involve dysfunction of the dopamine system in the brain.[3] The diagnosis is recognized by the American College of Emergency Physicians but is not in the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases.[1][4]

Treatment initially includes medications to sedate the person such as ketamine or midazolam and haloperidol injected into a muscle.[2] Rapid cooling may be required in those with high body temperature.[1] Other supportive measures such as intravenous fluids and sodium bicarbonate may be useful.[1] The risk of death among those affected is less than 10%.[1] If death occurs it is typically sudden and cardiac in nature.[1]

How frequently cases occur is unknown.[1] Males are affected more often than females.[5] Those who die from the condition are typically male with an average age of 36.[1] Often law enforcement has used tasers or physical measures in these cases.[1] A similar condition was described in the 1800s and was referred to as "Bell's mania".[1] The term "excited delirium" did not come into use until the 1980s.[1]

References

[edit]
  1. ^ a b c d e f g h i j k l m n o p q r s t u Vilke, GM; DeBard, ML; Chan, TC; Ho, JD; Dawes, DM; Hall, C; Curtis, MD; Costello, MW; Mash, DC; Coffman, SR; McMullen, MJ; Metzger, JC; Roberts, JR; Sztajnkrcer, MD; Henderson, SO; Adler, J; Czarnecki, F; Heck, J; Bozeman, WP (November 2012). "Excited Delirium Syndrome (ExDS): defining based on a review of the literature". The Journal of Emergency Medicine. 43 (5): 897–905. doi:10.1016/j.jemermed.2011.02.017. PMID 21440403.
  2. ^ a b Gerold, KB; Gibbons, ME; Fisette RE, Jr; Alves, D (2015). "Review, clinical update, and practice guidelines for excited delirium syndrome". Journal of Special Operations Medicine. 15 (1): 62–9. PMID 25770800.
  3. ^ a b c Mash, DC (2016). "Excited Delirium and Sudden Death: A Syndromal Disorder at the Extreme End of the Neuropsychiatric Continuum". Frontiers in Physiology. 7: 435. doi:10.3389/fphys.2016.00435. PMC 5061757. PMID 27790150.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  4. ^ Vilke, Gary M.; Payne-James, J. Jason (2016). Current Practice in Forensic Medicine. John Wiley & Sons, Ltd. pp. 97–117. doi:10.1002/9781118456026.ch6. ISBN 9781118456026.
  5. ^ Gonin, P; Beysard, N; Yersin, B; Carron, PN (May 2018). "Excited Delirium: A Systematic Review". Academic Emergency Medicine. 25 (5): 552–565. doi:10.1111/acem.13330. PMID 28990246.