Overview, Causes, & Risk Factors
Confusion is an abnormal mental condition or state of mind.
A person who is confused has trouble understanding the environment
and may react or respond inappropriately to it.
What is going on in the body?
Confusion is often a sign of an underlying problem or illness.
The causes range from mild to serious. Confusion may come on suddenly
or may occur gradually over time. Many causes of confusion are reversible.
What are the causes and risks of the symptom?
There are many possible causes of confusion, including:
being in an unfamiliar situation. For example, roughly 30% of people who
get admitted to a hospital intensive care unit
become confused during their stay. Being sick and in an unusual situation
causes enough stress
to make many people become confused.
a sudden illness, especially when the illness is severe. This is most likely
to occur in young children and elderly persons. Even the
can cause confusion in some people. Other infections, such as the brain infections
and a serious blood infection called sepsis,
commonly cause confusion.
illegal drugs, alcohol,
and some medicines
withdrawal from drugs or alcohol
low blood sugar, known as hypoglycemia
brain damage, such as that from Alzheimer disease,
a brain tumor,
or a stroke
fluid and salt imbalances,
such as low sodium
vitamin or mineral deficiency, such as
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chronic or serious infections or illnesses, such as
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chronic obstructive pulmonary disease,
chronic renal failure,
or heart attacks
hormone imbalances, such as low thyroid levels or
There are many other causes of confusion. Sometimes, a
cause cannot be found.
Symptoms & Signs
What other signs and symptoms are associated with this symptom?
People who are confused may exhibit the following signs and
They don't know who they are or where they are.
They don't know what time it is or even what year it is.
They are drowsy.
They are not able to concentrate or pay attention.
They misunderstand the things they see or hear.
They show poor judgment.
They have problems with coordination or movement.
They may be restless or agitated.
They have trouble remembering recent events.
Other symptoms are often related to the cause of the confusion.
Diagnosis & Tests
How is the symptom diagnosed?
When someone is confused, the doctor will try to determine the
cause. A medical history and physical exam is done first. In some cases,
this may be all that is needed to figure out the cause. Further testing is
often needed, however.
Blood tests are commonly done to help check for salt or
hormone imbalances, liver disease, and many other conditions. Urine
testing can help rule out an infection or kidney problem. A chest X-ray
can be done to look for lung conditions, such as pneumonia.
Other tests may be needed in some cases. For example, a cranial CT scan
can be done to look for a stroke or brain tumor.
Prevention & Expectations
What can be done to prevent the symptom?
Prevention is related to the cause of the confusion. For example,
avoiding certain drugs can prevent the confusion that can be caused by
them. Wearing a helmet when riding a bike or motorcycle and following
sports safety guidelines for children,
can help prevent head injuries. However, many causes cannot be prevented.
What are the long-term effects of the symptom?
Long-term effects are related to the cause of the confusion.
For example, confusion caused by an infection often goes away once
the person gets over the infection. An individual with
or chronic liver disease often dies from those conditions. In some people,
confusion may get worse over time and become permanent, such as in
What are the risks to others?
Confusion itself is not catching and poses no risk to others.
If confusion is the result of an infection, the infection may be contagious.
Treatment & Monitoring
What are the treatments for the symptom?
Treatment is directed at the cause of the confusion.
A person who develops confusion while in the hospital may simply need
someone to reorient him or her to the time and place.
An individual with low blood sugar may need to drink a sweet drink or eat a
A person who formerly used drugs usually gets better when the
drug is stopped.
An individual with an infection may need antibiotics.
A person with kidney failure may need dialysis, which is a
procedure that filters the blood when the kidneys don't work.
Someone with cancer may need chemotherapy,
What are the side effects of the treatments?
All medicines have possible side effects. For example,
antibiotics may cause allergic reactions
or stomach upset. Surgery carries a risk of bleeding, infection, and
to the anesthesia.
What happens after treatment for the symptom?
In many cases, confusion goes away when the cause is treated.
In other cases, confusion may be a sign of more serious disease. Some
causes of confusion such as stroke
and Alzheimer disease
may cause permanent brain damage and problems with brain function.
How is the symptom monitored?
A confused person should not be left alone. Other monitoring
depends on the underlying cause. For example, those who have had a
stroke often need close monitoring in an intensive care unit
for awhile. Any new or worsening symptoms should be reported to the doctor.