Confusion: what are the causes of acute, sudden confusion and disorientation?

Confusion, also called disorientation, amnesia, or otherwise confusion, is a qualitative disorder of consciousness. There is a disturbance in perception, thinking, and instability of emotions. Overall, confusion is a disturbance in the perception of reality.

It can be temporary and last only a short time, but it can also be long-term or permanent. It occurs acutely (suddenly, quickly) or chronically (long-term).

As such, it is actually a cognitive disorder. The brain is unable to cope with a new situation. It is a qualitative disorder of consciousness, and may be associated with temporary memory loss. The person usually cannot remember the period of disorientation, sometimes a short period before and after.

The disorientation may be spatial (the person does not know where they are), temporal (they cannot tell the date or current time) or personal. But it may be complex disorientation.

Confusion as a symptom of the disease

Confusion is a typical symptom of several diseases. For example, in diseases of the nervous system, in metabolic disorders. It is a part of psychiatric disorders.

Neurological causes

In most cases, confusion is associated with neurological disorders, most often, for example, Alzheimer's disease. This is a serious disease that affects mainly older people. This disease causes irreversible changes in brain cells, which is manifested by confusion and also memory problems.

Sometimes disorientation can also be present in Parkinson's disease, which is also associated with Alzheimer's. In this case, it is mainly problems with coordination of movements.

People with migraine may also experience some degree of internal confusion, albeit to a lesser extent. Migraine is also a disease of the nervous system. It is manifested by an intense headache, usually in one half of the head, which lasts for several hours.

In people with epilepsy, confusion may be present after an epileptic seizure. With full-body convulsions, impaired consciousness is present. When a person wakes up after a seizure, he or she may be disoriented.

There is also memory loss, retrograde and sometimes anterograde amnesia. In retrograde amnesia, the person has no memory of the circumstances before the seizure. In anterograde amnesia, the person has no memory of the circumstances shortly after waking up.

Psychiatric disorders

It is typically present in psychiatric disorders. An example is delirium, often as a consequence of alcoholism. Like delirium, dementia can be associated with alcoholism. Or as a consequence of another illness.

Information on delirium in a separate article.

Various psychotic conditions, organic psychosyndrome. May be part of a sleep disorder, attention disorder. Accompanied by psychomotor restlessness, tremor. Hallucinations and delusions may be associated.

Poisoning, drugs, psychotropic substances, alcohol and confusion

Disorientation usually occurs suddenly, but momentarily and temporarily, for example in the case of intoxication (poisoning). The cause may be high levels of alcohol or narcotic and psychotropic substances, drugs.

Intoxication can be accidental, but also intentional. Poisoning by psychopharmaceuticals is common. Poisoning and also oxygen deficiency can be caused by carbon monoxide, when burning, as an exhaust gas. This condition passes the moment the organism gets rid of these toxic substances or the person is placed outside their influence.

It can also occur when medicines are used incorrectly. For example, medicines for insomnia, nervousness and depression. Similarly, after anaesthesia, i.e. in the post-operative period.

Even in heart attack and stroke

In myocardial infarction, it occurs in approximately 13% of cases. Even if its course is asymptomatic. Infarction is an acute ischemia, a bloodlessness of the heart muscle, caused by blockage of a blood vessel by a clot, thrombosis. This condition is also manifested by chest pain and pain shooting into the left shoulder.

Orientation problems can also occur in stroke. In this case, the mechanism is similar to that of a heart attack. The difference is that any narrowing or blockage of the vessel occurs at the level of the head, i.e. the brain.

As a result of an acute blockage of a blood vessel that nourishes the brain due to a blood clot, the supply of oxygenated blood to the brain is interrupted. This condition can cause both temporary and permanent brain damage.

Early recognition of stroke symptoms, early examination, CT scan and effective treatment are important. When delayed or neglected, brain damage is more extensive. In the elderly, confusion can also occur in the case of anemia, where there is inadequate oxygenation to the brain and other organs.

Disorientation after injury

Concussion is a similarly dangerous condition. It occurs as a result of an accident, fall, blow or other head injury. Confusion is one of the symptoms of concussion. In addition to it, there may be a short-term impairment of consciousness, as well as a feeling of nausea, vomiting and memory loss, similar to that after an epileptic seizure.

Inflammation, infection and disorientation

Confusion is also typical of many infectious and inflammatory febrile illnesses. It is often intermingled with delirium in various fevers and infectious diseases of the respiratory system.

The brain can also be damaged by various inflammations, such as meningitis, technically known as meningitis. Inflammation can be caused by viruses or bacteria and there are several types of inflammation depending on the causative agent. It is most commonly manifested by headaches and muscle stiffness in the neck.

Infectious diseases that can cause confusion include yeast infection if it attacks the nervous system. The person suffers from insomnia, depression, fatigue and concentration disorders.

Also in syphilis, which is a sexually transmitted disease. Its late stage is characterized by attack on the heart, brain, spinal cord. It leads to psychological, mental, disorders. The final stage is death.

Other causes of disorientation

Disorientation (confusion) is also manifested by other diseases and deterioration of health. The psyche is affected by the activity of various body systems.

It also arises in disease, but also in deterioration of health, such as:

• fever, especially in young children and the elderly
• hypoglycaemia, i.e. low blood sugar
• hyperglycaemia, a lot of sugar in the blood
• heart failure
• low and high blood pressure
• metabolic upset
• dehydration
• liver disease, when its function fails
• kidney failure in the elderly and in pain
• hypothermia or overheating of the body
• tumour
• malfunction of endocrine glands, thyroid, adrenal glands
• reduced blood supply to the brain, also in respiratory diseases