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Confusional Arousal

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1. Confusional Arousal

Confusional Arousal Confusional Arousal Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Confusional Arousal Confusional Arousal Aka (...) : Confusional Arousal , Sleep Drunkenness II. Epidemiology Age 3 to 13 years old: 17.3% Age over 15 years old: 2.9 to 4.2% No gender predominance (girls and boys equally affected) Familial inheritance component III. Symptoms Inappropriate behavior Slowed responses Slurred speech Confusion after awakening No memory of event Timing Onset during first half of sleep IV. Management Reassure family Episodes resolve without intervention Treat as with other parasomnias See Counsel on home safety V. References

2018 FP Notebook

2. Are confusional arousals pathological? (PubMed)

Are confusional arousals pathological? The objective of this study was to determine the extent that confusional arousals (CAs) are associated with mental disorders and psychotropic medications.Cross-sectional study conducted with a representative sample of 19,136 noninstitutionalized individuals of the US general population aged 18 years or older. The study was performed using the Sleep-EVAL expert system and investigated sleeping habits; health; and sleep, mental, and medical conditions (DSM

2014 Neurology

3. Confusional Arousal

Confusional Arousal Confusional Arousal Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Confusional Arousal Confusional Arousal Aka (...) : Confusional Arousal , Sleep Drunkenness II. Epidemiology Age 3 to 13 years old: 17.3% Age over 15 years old: 2.9 to 4.2% No gender predominance (girls and boys equally affected) Familial inheritance component III. Symptoms Inappropriate behavior Slowed responses Slurred speech Confusion after awakening No memory of event Timing Onset during first half of sleep IV. Management Reassure family Episodes resolve without intervention Treat as with other parasomnias See Counsel on home safety V. References

2015 FP Notebook

4. Arousal in Nocturnal Consciousness: How Dream- and Sleep-Experiences May Inform Us of Poor Sleep Quality, Stress, and Psychopathology (PubMed)

Arousal in Nocturnal Consciousness: How Dream- and Sleep-Experiences May Inform Us of Poor Sleep Quality, Stress, and Psychopathology The term "sleep experiences," coined by Watson (2001), denotes an array of unusual nocturnal consciousness phenomena; for example, nightmares, vivid or recurrent dreams, hypnagogic hallucinations, dreams of falling or flying, confusional arousals, and lucid dreams. Excluding the latter, these experiences reflect a single factor of atypical oneiric cognitions (...) ("general sleep experiences"). The current study is an opinionated mini-review on the associations of this factor-measured with the Iowa sleep experiences survey (ISES, Watson, 2001)-with psychopathological symptoms and stress. Findings support a strong relation between psychological distress and general sleep experiences. It is suggested that that they should be viewed as a sleep disturbance; they seem to represent involuntary intrusions of wakefulness into sleep, resulting in aroused sleep

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2017 Frontiers in psychology

5. Confusional States and Acute Memory Disorders (Follow-up)

Confusional States and Acute Memory Disorders (Follow-up) Delirium: Practice Essentials, Background, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjg4ODkwLW92ZXJ2aWV3 processing > Delirium (...) reduced preoperative plasma cholinesterase activity in as many as one quarter of patients. In addition, reduced preoperative cholinesterase levels were significantly correlated with postoperative delirium. [ ] Clinically, good reasons support this hypothesis. Anticholinergic medications are a well-known cause of acute confusional states, and patients with impaired cholinergic transmission, such those with Alzheimer disease, are particularly susceptible. In patients with postoperative delirium, serum

2014 eMedicine.com

6. Confusional States and Acute Memory Disorders (Diagnosis)

Confusional States and Acute Memory Disorders (Diagnosis) Delirium: Practice Essentials, Background, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjg4ODkwLW92ZXJ2aWV3 processing > Delirium (...) reduced preoperative plasma cholinesterase activity in as many as one quarter of patients. In addition, reduced preoperative cholinesterase levels were significantly correlated with postoperative delirium. [ ] Clinically, good reasons support this hypothesis. Anticholinergic medications are a well-known cause of acute confusional states, and patients with impaired cholinergic transmission, such those with Alzheimer disease, are particularly susceptible. In patients with postoperative delirium, serum

2014 eMedicine.com

7. Confusional States and Acute Memory Disorders (Treatment)

Confusional States and Acute Memory Disorders (Treatment) Delirium: Practice Essentials, Background, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjg4ODkwLW92ZXJ2aWV3 processing > Delirium (...) reduced preoperative plasma cholinesterase activity in as many as one quarter of patients. In addition, reduced preoperative cholinesterase levels were significantly correlated with postoperative delirium. [ ] Clinically, good reasons support this hypothesis. Anticholinergic medications are a well-known cause of acute confusional states, and patients with impaired cholinergic transmission, such those with Alzheimer disease, are particularly susceptible. In patients with postoperative delirium, serum

2014 eMedicine.com

8. Confusional States and Acute Memory Disorders (Overview)

Confusional States and Acute Memory Disorders (Overview) Delirium: Practice Essentials, Background, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjg4ODkwLW92ZXJ2aWV3 processing > Delirium Updated (...) plasma cholinesterase activity in as many as one quarter of patients. In addition, reduced preoperative cholinesterase levels were significantly correlated with postoperative delirium. [ ] Clinically, good reasons support this hypothesis. Anticholinergic medications are a well-known cause of acute confusional states, and patients with impaired cholinergic transmission, such those with Alzheimer disease, are particularly susceptible. In patients with postoperative delirium, serum anticholinergic

2014 eMedicine.com

9. Cocaine abuse

Cocaine abuse Cocaine abuse - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Cocaine abuse Last reviewed: February 2019 Last updated: April 2018 Summary Episodic cocaine use leads to short-lived states of autonomic arousal. Chronic use can lead to scarring of heart tissue and myocardial hypertrophy and other changes collectively known as myocardial remodelling. These changes constitute the substrate for the occurrence (...) users as an isolated condition or as a feature of 'excited delirium'. It is an agitated confusional state associated with potentially lethal hyperthermia. There is no evidence to support the use of antipsychotic agents for cocaine dependence. Antipsychotic agents may cause QT interval prolongation and, when used concomitantly with cocaine, may compound the risk of sudden death. Definition Cocaine is a drug of abuse that is usually either insufflated (snorted), injected, or smoked in its freebase

2018 BMJ Best Practice

10. Parasomnias in children

Parasomnias in children Parasomnias in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Parasomnias in children Last reviewed: February 2019 Last updated: February 2018 Summary The most common non-rapid eye movement (NREM) parasomnias in children are the disorders of arousal (e.g., sleepwalking, night terrors, and confusional arousals), which occur most commonly in the first half of the night. Rapid eye (...) paediatric parasomnias are benign, self-limited, and generally do not persist into adulthood. Mason TB 2nd, Pack AI. Pediatric parasomnias. Sleep. 2007;30:141-151. http://www.ncbi.nlm.nih.gov/pubmed/17326539?tool=bestpractice.com The term 'disorder of arousal' is used to imply incomplete arousal from non-rapid eye movement (NREM) sleep, manifesting with parasomnias. This monograph will cover confusional arousals, sleepwalking, sleep terrors, nightmares, isolated recurrent sleep paralysis, and rapid eye

2018 BMJ Best Practice

11. Parasomnias in adults

/deprivation normal physical examination between episodes cognitive disturbance during event (confusional arousals, sleep terrors, and sleepwalking) cognitive disturbances in between episodes (rapid eye movement sleep behaviour disorder [RBD]) sensation of a sudden loud noise in the head (exploding head syndrome) vigorous or violent behaviour (confusional arousals, sleepwalking, sleep terrors, and rapid eye movement sleep behaviour disorder [RBD]) episodes of inability to move (recurrent isolated sleep (...) paralysis) eating behaviour during the night (sleep-related eating disorder) evidence of external injuries (rapid eye movement sleep behaviour disorder [RBD]) autonomic hyperactivity during event (sleep terrors, nightmare disorder) low socioeconomic status and low educational level (rapid eye movement sleep behaviour disorder [RBD]) cardiovascular risk factors (rapid eye movement sleep behaviour disorder [RBD]) abnormal facial expression (confusional arousals, sleepwalking, sleep terrors, rapid eye

2018 BMJ Best Practice

12. Delirium

have questions please contact us via jon.brassey@tripdatabase.com Top results for delirium 1. Delirium Delirium - NICE CKS Clinical Knowledge Summaries Share Delirium : Summary Delirium (sometimes called 'acute confusional state') is an acute, fluctuating syndrome of inattention, impaired level of consciousness, and disturbed cognition. Delirium can be classified into subtypes based on symptoms: Hyperactive delirium can present with inappropriate behaviour, hallucinations, or agitation. Hypoactive (...) in validated and reliable tools such as arousal scales and bedside delirium monitoring instruments. Once delirium is recognized and the modifiable 2012 7. Non-pharmacological interventions for delirium in critically ill patients Non-pharmacological interventions for delirium in critically ill patients PROSPERO International prospective register of systematic reviews Non-pharmacological interventions for delirium in critically ill patients Leona Bannon, Bronagh Blackwood, Danny McAuley, Mike Clarke Citation

2018 Trip Latest and Greatest

13. Practice Guideline Update Systematic Review Summary: Disorders of Consciousness

diagnostic assessment procedures that incorporate the Aspen Neurobehavioral Workgroup criteria accurately detect behavioral signs of consciousness or differentiate specific DoCs (VS/UWS, MCS, and posttraumatic confusional state [PTCS]) compared with consensus-based diagnostic opinion or standardized behavioral assessment. Readers are referred to a previously published systematic review completed by the ACRM Disorders of Consciousness Task Force that provides evidence-based recommendations for clinical

2018 American Academy of Neurology

14. Management of Posttraumatic Stress Disorder and Acute Stress Reaction

electronic media, television, movies, or pictures, unless this exposure is work related. Criterion B. Presence of nine (or more) of the following symptoms from any of the five categories of intrusion, negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic event(s) occurred: Intrusion Symptoms 1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s) 2. Recurrent distressing dreams in which the content and/or affect of the dream (...) memories, thoughts, or feelings about or closely associated with the traumatic event(s) 9. Efforts to avoid external reminders (e.g., people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s) Arousal Symptoms 10. Sleep disturbance (e.g., difficulty falling or staying asleep, restless sleep) 11. Irritable behavior and angry outbursts (with little or no provocation), typically expressed

2017 VA/DoD Clinical Practice Guidelines

15. CRACKCast E017 – Confusion

– it reflects recent change in behaviour. Do no overlook subtle confusion in the elderly, as it is an independent risk factor for increased mortality. Confusion is a spectrum, ranging from: Mild impairment of short-term memory Delirium – a global inability to relate to environment and process sensory input: Hyperactive Delirium Hypoactive Delirium Acute confusional state with triad of: Increased alertness Increased psychomotor activity Disorientation +/- hallucinations Acute confusional state (...) with: Decreased alertness Decreased behaviour Varied Terminology for Confusion: Altered mentation Change in mental status Altered mental status Change from baseline “Different” Pathophysiology Again as discussed in chapter 16, Consciousness in made up of arousal and content , which are controlled by the ARAS and cerebral cortex respectively. With confusion, we are really talking about issues with content , or cortical disruption . Three major categories can impact and disrupt normal cortical function

2016 CandiEM

18. Delirium

Delirium Scottish Palliative Care Guidelines - Delirium Scottish Palliative Care Guidelines search / / / Delirium Delirium Introduction In this guideline, delirium is defined as disturbed consciousness and inattention with cognitive impairment; acute onset and fluctuating course as a physiological consequence of disease or treatment. Delirium is often reversible. Other terms used to describe delirium include acute confusional state, agitation, and terminal restlessness, but the terms (...) restlessness and terminal agitation should be used once reversibility excluded. Assessment Common (30 to 85% of hospice patients), often reversible but diagnosed late Three types: hyperactive – increased arousal and agitation hypoactive – quiet, withdrawn and inactive: more common but often missed or misdiagnosed as depression mixed pattern Diagnosis depends mainly on careful clinical assessment; consider using Mini-mental state examination (MMSE) or Confusion assessment method (CAM) as a screening tool

2015 Scottish Palliative Care Guidelines

19. Multiple sclerosis

survey of men with MS (n = 67) found the most common sexual function related complaints were erectile dysfunction (52.9%), decreased sexual desire (26.8%), and difficulties in reaching orgasm (23.1%) or ejaculation (17.9%). However, in this survey, only 6% of people had ever discussed their sexual concerns with a healthcare professional [ ]. One survey of women with MS (n = 137) found the most common sexual function related complaints were decreased sexual desire (57.7%), arousal dysfunction (...) (decreased genital sensation in 47.3%, decreased lubrication in 48.4%, decreased subjective arousal in 45.2%) and orgasmic dysfunction (39.8%). However, in this survey, only 2.2% of people had ever discussed their sexual concerns with a healthcare professional [ ]. Mental health problems — people with MS have: An increased risk of developing depression, anxiety, bipolar disorder, and psychosis compared to the general population [ ]. An increased risk of suicide and suicide ideation compared

2018 NICE Clinical Knowledge Summaries

20. Chronic Insomnia in Older Adults

when sleepy Ö Use the bed/bedroom only for sleep & sex do not watch TV Ö Do not stay in bed longer than 15-20 minutes if unable to sleep Sleep-restriction ‡ (limit time in bed that will lead to sleep deprivation to result in ? in homeostatic drive & sleep efficiency) Cognitive therapy (alters faulty beliefs & attitudes about sleep) Relaxation (biofeedback; promotes relaxation & È arousal prior to bed) Ö Relax muscles throughout body, breathing patterns, direct attention from everyday thoughts (...) with sunlight) for 30-40 minutes upon awakening (average indoor lighting is 300-500 lux, average sunny summer day is 100,000 lux) Sleep-restriction (limit time in bed that will lead to sleep deprivation to result in ? in homeostatic drive & sleep efficiency) Cognitive therapy (alters faulty beliefs & attitudes about sleep) Relaxation (biofeedback; promotes relaxation & È arousal prior to bed) Ö Relax muscles throughout body, breathing patterns, direct attention from everyday thoughts by using a mental

2013 RxFiles

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