Confusion

What is confusion?

Confusion is a change in memory, attention, or awareness. Confusion includes puzzling or odd behavior or responses. A confused person may not be aware of what is going on around them. They may not know where they are or what time it is. Their attention wanders and they are easily distracted. Their memory may be affected. They may have trouble speaking or understanding what others say. Confused people cannot think clearly and have trouble making decisions. They may see or hear things that aren't there.

Confusion that happens as a sudden change is called acute confusion. It may also come on gradually over time. Confusion of either type is often a sign of another problem and may range from mild to severe.

How does it occur?

Confusion has many possible causes. It can be caused by an injury, tumor, or diseases of the brain such as Alzheimer's or Parkinson's. Changes in the normal balance of the body's oxygen, blood sugar, temperature, or fluid and electrolytes can cause confusion. An illness or a sinus infection are also causes. Even stress, too little sleep, lack of certain vitamins, or taking some herbal remedies can cause symptoms, especially in older adults. Sometimes new medicines cause problems. Drugs or alcohol can cause confusion if you use them to excess or abuse them. Confusion can occur when those who regularly use alcohol or drugs abruptly stop using them.

What are the symptoms?

Signs and symptoms of confusion can include:

• being unable to concentrate, pay attention, or remember
• drowsiness
• not knowing who they are, where they are, what day or year it is
• misunderstanding what is seen or heard
• being restless or agitated.

How is it diagnosed?

A confused person may not be aware that they are confused. Family members or friends may need to describe how long the person has had symptoms and if the confusion started suddenly or came on gradually. The provider will do a physical exam and ask about medical history. The healthcare provider will check that the symptoms are not caused by medicines or by a condition that can be treated. The provider may also ask the person some questions to test memory and thinking and to check for depression.

The following tests also may be done:

• blood tests
• CT scan or an MRI
• EEG, or electroencephalogram, to check for problems in the brain
• EKG, or electrocardiogram, to check for heart problems
• urine tests
• X-rays.

How is it treated?

Treatment depends on what caused the confusion. For example changing medicines, treating the disease, or reducing stress may take care of confusion.

Call for emergency medical help if the confusion came on suddenly, and the person has other symptoms such as headache, dizziness, clammy skin, fever, or an abnormal pulse or breathing. It is also an emergency if a person is a known diabetic, has a head injury, or becomes unconscious. A confused person should never be left alone.