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CHRONIC CONFUSION
Chronic confusion is defined as a confusional state that lasts longer than three months. There are many causes of chronic, long-term confusion that can be reversed or greatly helped. The main differentiation, though, is between these treatable causes and the conditions known as ‘dementia’.
Chronic confusional states are very important because of the reversible causes – no one should be diagnosed ‘demented’ until they have had a thorough screening for the treatable conditions. The diagnosis can often be very difficult and need more than one period of assessment; for example, because of the time scale involved it is often difficult for carers to pinpoint when things started to go wrong. There is no delirium, as in acute confusional states, and the problems vary with the underlying diagnosis. Memory loss and disorientation are common but often the presentation is of someone failing to cope at home. The condition ‘failure to cope’ should always ring alarm bells.
The following is a list of conditions which will be discussed further. Many of them are entirely reversible, some not so. An accurate diagnosis of the confusion has marked implications for both the sufferer and carers. The discussion includes diagnosis (both by carer and doctor) and treatment.
• Hypothyroidism
• Vitamin B12 and folic acid deficiency
• Syphilis
• Depression
• Head injury and brain tumour (benign and malignant)
• Normal pressure hydrocephalus
• Parkinson’s disease
• Alcohol
*15/128/5*

