Unexpected Delirium Without Recovery: Seeking Insight
Greetings, I am reaching out in hopes of finding some guidance. My mother, who is 72 years old and assigned female at birth, experienced a rapid onset of delirium beginning last Monday (June 23). Since then, she has been hospitalized. To give you some context, on the preceding Sunday (June 22), she exhibited no signs of cognitive impairment whatsoever. The medical team has been conducting tests daily, yet all results appear to indicate a healthy status. Her metabolic panels are consistently normal, and both a CT scan and an MRI have shown no abnormalities aside from indications of encephalopathy. Additionally, her vitamin levels are adequate, and she has not started any new medications; she has been on the same prescriptions for many years. The doctors remain perplexed about the situation, and I am filled with anxiety over her condition. I would appreciate any thoughts or insights on potential underlying issues we might not be considering.
Answers (1)
7/1/2025, 1:01:29 PM
OpenHealth AI
I'm sorry to hear about your mother's sudden onset of delirium; that can be incredibly distressing for both her and your family. Given that her medical team is actively investigating her condition, it’s important to consider all potential causes of delirium in older adults, especially since her tests are showing no clear abnormalities.
Main Points:
- Delirium can stem from many underlying issues, even if initial tests appear normal.
- Common non-medical factors may include infections, dehydration, metabolic imbalances, or psychological stressors.
- Continue to communicate openly with her healthcare team and inquire about ongoing assessments.
Explanation:
Delirium is typically a temporary state of confusion that can be caused by various factors, including infections (like urinary tract infections), drug side effects, dehydration, metabolic changes, or even recent changes in her environment. Encephalopathy, which may show on her imaging, suggests a potential dysfunction of the brain's normal operation, which can sometimes accompany delirium but needs further clarification.
While you're awaiting more answers, it may help to keep these considerations in mind:
- Infections: Sometimes, infections are not immediately obvious. Ask the medical team if they are considering tests for less common infections (e.g., viral, or related to the urinary system).
- Dehydration or Nutritional Status: Ensure hydration is monitored, as dehydration can quickly lead to confusion, especially in older adults. Sometimes, nutritional deficits, even if vitamin levels are adequate, can play a role.
- Environmental Factors: Changes in environment or routine can lead to stress and confusion, particularly in older adults. Consistent visitation and familiar items from home could help soothe her.
- Neurological Issues: Even when initial scans are normal, there might be subtle neurological changes that require further evaluation by a specialist, particularly if symptoms persist.
Next Steps:
- Inquire About Further Testing: Ask doctors if they can consider other tests for less common infections or metabolic issues.
- Ensure She's Hydrated: If possible, monitor her fluid intake, especially if the hospital is not addressing hydration adequately.
- Enhance Comfort: Bring in items from home that could comfort her — family photos, a favorite blanket, or anything that feels familiar.
- Document Changes: Keep a record of any changes in her condition. This can help guide discussions with her healthcare team.
It’s understandable to feel anxious during this uncertain time. Maintaining close communication with her medical team will be crucial as they work to identify underlying causes and to ensure the best care for your mother. Please feel free to reach out if you have additional questions or need more information.
Related Questions
Impact of Tegretol Overdose at Age 7
As a woman now in her late thirties, I reflect back on a significant event from my childhood. At just seven years old, I accidentally ingested a large quantity of Tegretol, a medication prescribed to my brother for his epilepsy. Without realizing the danger, I swallowed a handful of those pills and fell asleep on the couch next to my mother. To my surprise, I regained consciousness a week later in a hospital bed. My mother recounted that I had suffered a seizure, at which point she found herself unable to awaken me, leading to a state of coma. Once I awoke, the emotional shift was profound; I transitioned from sadness to experiencing a tumultuous range of feelings. I am now curious about how such an overdose could have impacted my brain function. I attempted to search online for insights but came up empty-handed. Any information or shared experiences related to brain effects from similar situations would be greatly appreciated. Thank you in advance!
Unexplained Symptoms Over the Past Few Years
Greetings, Around three years ago, I started to experience a variety of symptoms that appeared quite abruptly. They seemed to improve briefly, only to return later. This initial onset threw me into a panic, leading me to suspect something severe, like cancer. After consulting my physician, I underwent tests through a neurologist and had multiple lab analyses, yet no definitive diagnosis emerged. Frustrated by the ongoing uncertainty, I ceased my attempts to find answers and have not revisited the doctor for these issues in years. This situation dates back to approximately 2021, coinciding with my time as a nursing student. While I can't be sure if there's a connection, it was around this period that I contracted COVID-19 for the first time and also received my annual flu shot as part of my nursing curriculum. Additionally, I was treated for melanoma during this time, undergoing a Mohs procedure to eliminate it, which was part of the initial anxiety surrounding my symptoms. Below are the symptoms I’ve documented: The first change I noticed was an unrelenting muscle fatigue. Simple tasks such as carrying groceries or working outdoors left me feeling immensely winded. I began to realize that the muscles in my neck felt excessively weak, and my arms and legs, although still functional, felt distinctly weaker than before. Although I could still perform my usual activities, I often felt unsteady, especially when descending stairs. Shortly thereafter, I began suffering from frequent muscle cramps at night and persistent twitching in my muscles during the day, particularly in my legs. I also observed involuntary movements in the inner arches of my feet, which, while somewhat common, were consistently present and unusual for me. Another concerning symptom was the onset of intermittent blurred vision. This issue varies in intensity, making it particularly troublesome during episodes that seem to flare up, often exacerbated by bright lighting, like that from screens or sunlight streaming through open windows. I found myself increasing the font size on screens and printed material because reading became quite challenging. While I haven’t seen an eye care professional yet, the suddenness of these vision problems caught me off guard. Additionally, I observed a significant size disparity between the muscles in my arms; my left arm appeared noticeably bulkier than my right. As a left-handed individual, I had never paid much attention to this before, though it’s possible it’s been like this for some time. The most perplexing symptom, one that’s been difficult to research, involves my right shoulder area. The deltoid region developed an odd squishy sensation. This prompts me to mention the flu and COVID-19 vaccinations. I’ve found no information on this symptom, and inquiries yield little guidance. Initially, it felt as if a lump had developed beneath my deltoid. Gradually, the entire area became squishy, resembling fibrous, lumpy tissue rather than muscle. In contrast, when I flex my left arm, it feels muscular and firm, whereas the right arm feels substantially softer. This strange condition raises questions—could a flaw in the vaccine administration by classmate healthcare students have contributed to this issue, or is it related to my other unexplained symptoms? As for medical evaluations, my Basic Metabolic Panel and Magnesium levels were unremarkable, as was my Complete Blood Count. Further inflammatory markers including CRP, CK, and ESR all returned normal results. My hemoglobin A1c was towards the high end of normal but did not classify as pre-diabetic. Autoimmune tests yielded no significant findings, and a nerve conduction study did not reveal any abnormal results either. The results from an EMG suggested mild increased insertional activity in several tested muscles, though it was deemed possibly normal, yet it might indicate an EMG disease. Unfortunately, I was unable to undergo MRI imaging due to insurance challenges at that time. I am a 42-year-old male with no significant past medical history beyond the prior melanoma and not currently using medication, aside from over-the-counter Benadryl for sleep issues. Apologies for the detailed narrative, but I felt this could be a valuable forum for seeking perspectives. I appreciate your time. It’s important to clarify that I am not prone to hypochondria; prior to these developments, I rarely sought medical care and, oddly enough, didn’t even have a primary care provider when these symptoms began.
Young Plumber with Herniated Discs Seeks Guidance
Greetings, medical professionals. I am a 17-year-old plumber who has dedicated the past two years to this trade, beginning when I was just 15. About two years ago, I was involved in a car accident that led to the discovery of three herniated discs: one located in my upper back, while the other two are situated in the mid to lower back region. While it's possible that these injuries stemmed from the accident, I suspect they might not be entirely related. Interestingly, disc problems seem to be common in my family. I'm concerned about my prospects moving forward. What can I expect in terms of health as I age, especially regarding these injuries? Moreover, how can I prevent a situation where I may struggle with mobility in my 50s or 60s? For some time, my pain subsided, but recently, I've started to experience discomfort again in the mid to lower back area, reminiscent of what I felt initially. Any advice or insights would be greatly appreciated!
Inquiry Regarding FDG-PET Scan Findings
I recently underwent an FDG-PET/CT scan for my brain to investigate some cognitive difficulties I've been experiencing. Although the report is now available on My Chart, my follow-up appointment with the doctor is scheduled for three weeks from now. I have a query regarding the standard deviation scale presented in the report, which lists values from -2 to -4.6. What does the lowest value signify? Is the scale graded on a 1-5, 1-10, or perhaps 1-100 basis? I appreciate your assistance with this! Notable regions noted for decreased metabolic activity include: - Left Inferior frontal gyrus, triangularis: SD "4.6" - Left Heschl gyrus: SD "3.8" - Left Superior temporal gyrus: SD "3.6" - Left Middle temporal gyrus: SD "3.4" - Left Supramarginal gyrus: SD "2.6" - Left Inferior parietal lobule, supramarginal area: SD "2.1" Other areas displaying low metabolism are: - Right Superior frontal gyrus, medial: SD "3.2" - Left Superior frontal gyrus, medial: SD "2.2"
Seeking Clarity on a Pediatric Surgical Experience
One of my earliest recollections involves surgical gauze wrapped around my genitals and being cautioned to exercise caution regarding my circumcision. This incident dates back to around 1972, when I was roughly three years old. My brother, who was eleven at the time, corroborates this memory and recalls that the bandage remained in place for "a few weeks." His recollection is a bit unclear, but he does remember seeing me running around without pants and with a gauze dressing. He believes the dressing wasn't overly bulky and doesn't recall any stent being used. However, I am aware that his memory may not be completely accurate based on other conversations we've had. He recalls being informed that I underwent surgery for an undescended testicle, yet was never made aware of a circumcision being involved. Later, a physician indirectly confirmed that I had undergone an early orchidopexy. This memory piques my curiosity, particularly since my parents have never brought it up with me. I have knowledge of having glanular/coronal hypospadias, and the details of my situation appear to align with images I’ve encountered depicting partial hypospadias corrections. This leads me to wonder if my circumcision might have actually been related to hypospadias surgery. Unfortunately, any tangible proof of these events was lost when I underwent gender confirmation surgery as a trans woman three decades ago. It's conceivable that the standard circumcision procedure typically performed at birth could have been postponed, given that I was born slightly premature and had significant Rh disease and hypoxia. But could it have been deferred until I reached the age of three? I have made attempts to obtain my medical records, but unfortunately, they have been destroyed over the years. While I understand that definitive answers may be elusive, I would greatly appreciate any insights or thoughts on this matter.