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May 1991

Delirium: Acute Confusional States

Author Affiliations

London, Ontario

Arch Neurol. 1991;48(5):466-467. doi:10.1001/archneur.1991.00530170026009

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Delirium is an erudite, comprehensive treatment of a difficult yet important subject. Z. J. Lipowski deserves credit for bringing together many areas of widely discrepant opinions, descriptions, and explanations for the complex phenomena that can be observed in acute confusional states or delirium. As there is a great deal of variability in symptomatology, delirium is a difficult problem to study. The patients are usually quite ill, uncooperative, and difficult to examine, and the phenomena of delirium is transient. All of this explains the scarcity of systematized research and the abundance of anecdotal descriptions. Delirium is one of the few abnormal mental phenomena that has been experienced by almost everyone. Most of us have gone through a febrile state in childhood with vivid, dreamlike hallucinations and remember the horrifying experience.

The definition of delirium to encompass all forms of confusional states will not sit well with everybody. Most people would define

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