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Postseizure confusion

MedGen UID:
148224
•Concept ID:
C0751053
•
Pathologic Function
Synonyms: Confusion, Post Ictal; Confusion, Post-Ictal; Post-Ictal Confusion
SNOMED CT: Postseizure confusion (44031002); Postictal confusion (44031002); Postepileptic confusion (44031002)

Definition

A period of confusion following a seizure in which the patient does not respond appropriately despite appearing awake. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPostseizure confusion

Professional guidelines

PubMed

2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility.
Smith HAB, Besunder JB, Betters KA, Johnson PN, Srinivasan V, Stormorken A, Farrington E, Golianu B, Godshall AJ, Acinelli L, Almgren C, Bailey CH, Boyd JM, Cisco MJ, Damian M, deAlmeida ML, Fehr J, Fenton KE, Gilliland F, Grant MJC, Howell J, Ruggles CA, Simone S, Su F, Sullivan JE, Tegtmeyer K, Traube C, Williams S, Berkenbosch JW
Pediatr Crit Care Med 2022 Feb 1;23(2):e74-e110. doi: 10.1097/PCC.0000000000002873. PMID: 35119438
Delirium in critical illness: clinical manifestations, outcomes, and management.
Stollings JL, Kotfis K, Chanques G, Pun BT, Pandharipande PP, Ely EW
Intensive Care Med 2021 Oct;47(10):1089-1103. Epub 2021 Aug 16 doi: 10.1007/s00134-021-06503-1. PMID: 34401939Free PMC Article
Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU.
Devlin JW, Skrobik Y, Gélinas C, Needham DM, Slooter AJC, Pandharipande PP, Watson PL, Weinhouse GL, Nunnally ME, Rochwerg B, Balas MC, van den Boogaard M, Bosma KJ, Brummel NE, Chanques G, Denehy L, Drouot X, Fraser GL, Harris JE, Joffe AM, Kho ME, Kress JP, Lanphere JA, McKinley S, Neufeld KJ, Pisani MA, Payen JF, Pun BT, Puntillo KA, Riker RR, Robinson BRH, Shehabi Y, Szumita PM, Winkelman C, Centofanti JE, Price C, Nikayin S, Misak CJ, Flood PD, Kiedrowski K, Alhazzani W
Crit Care Med 2018 Sep;46(9):e825-e873. doi: 10.1097/CCM.0000000000003299. PMID: 30113379

Recent clinical studies

Etiology

Delirium in neurosurgery: a systematic review and meta-analysis.
Kappen PR, Kakar E, Dirven CMF, van der Jagt M, Klimek M, Osse RJ, Vincent APJE
Neurosurg Rev 2022 Feb;45(1):329-341. Epub 2021 Aug 16 doi: 10.1007/s10143-021-01619-w. PMID: 34396454Free PMC Article
Delirium in Hospitalized Older Adults.
Marcantonio ER
N Engl J Med 2017 Oct 12;377(15):1456-1466. doi: 10.1056/NEJMcp1605501. PMID: 29020579Free PMC Article
Delirium in Older Persons: Advances in Diagnosis and Treatment.
Oh ES, Fong TG, Hshieh TT, Inouye SK
JAMA 2017 Sep 26;318(12):1161-1174. doi: 10.1001/jama.2017.12067. PMID: 28973626Free PMC Article
Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial.
Su X, Meng ZT, Wu XH, Cui F, Li HL, Wang DX, Zhu X, Zhu SN, Maze M, Ma D
Lancet 2016 Oct 15;388(10054):1893-1902. Epub 2016 Aug 16 doi: 10.1016/S0140-6736(16)30580-3. PMID: 27542303
Clarifying confusion: the confusion assessment method. A new method for detection of delirium.
Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI
Ann Intern Med 1990 Dec 15;113(12):941-8. doi: 10.7326/0003-4819-113-12-941. PMID: 2240918

Diagnosis

Delirium.
Keenan CR, Jain S
Med Clin North Am 2022 May;106(3):459-469. Epub 2022 Apr 4 doi: 10.1016/j.mcna.2021.12.003. PMID: 35491066
Delirium in neurosurgery: a systematic review and meta-analysis.
Kappen PR, Kakar E, Dirven CMF, van der Jagt M, Klimek M, Osse RJ, Vincent APJE
Neurosurg Rev 2022 Feb;45(1):329-341. Epub 2021 Aug 16 doi: 10.1007/s10143-021-01619-w. PMID: 34396454Free PMC Article
Delirium in Hospitalized Older Adults.
Marcantonio ER
N Engl J Med 2017 Oct 12;377(15):1456-1466. doi: 10.1056/NEJMcp1605501. PMID: 29020579Free PMC Article
Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial.
Su X, Meng ZT, Wu XH, Cui F, Li HL, Wang DX, Zhu X, Zhu SN, Maze M, Ma D
Lancet 2016 Oct 15;388(10054):1893-1902. Epub 2016 Aug 16 doi: 10.1016/S0140-6736(16)30580-3. PMID: 27542303
Clarifying confusion: the confusion assessment method. A new method for detection of delirium.
Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI
Ann Intern Med 1990 Dec 15;113(12):941-8. doi: 10.7326/0003-4819-113-12-941. PMID: 2240918

Therapy

Decreasing delirium through music listening (DDM) in critically ill, mechanically ventilated older adults in the intensive care unit: a two-arm, parallel-group, randomized clinical trial.
Seyffert S, Moiz S, Coghlan M, Balozian P, Nasser J, Rached EA, Jamil Y, Naqvi K, Rawlings L, Perkins AJ, Gao S, Hunter JD 3rd, Khan S, Heiderscheit A, Chlan LL, Khan B
Trials 2022 Jul 19;23(1):576. doi: 10.1186/s13063-022-06448-w. PMID: 35854358Free PMC Article
Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients.
Burton JK, Craig LE, Yong SQ, Siddiqi N, Teale EA, Woodhouse R, Barugh AJ, Shepherd AM, Brunton A, Freeman SC, Sutton AJ, Quinn TJ
Cochrane Database Syst Rev 2021 Jul 19;7(7):CD013307. doi: 10.1002/14651858.CD013307.pub2. PMID: 34280303Free PMC Article
Effectiveness of Bundle Interventions on ICU Delirium: A Meta-Analysis.
Zhang S, Han Y, Xiao Q, Li H, Wu Y
Crit Care Med 2021 Feb 1;49(2):335-346. doi: 10.1097/CCM.0000000000004773. PMID: 33332818Free PMC Article
Interventions for preventing intensive care unit delirium in adults.
Herling SF, Greve IE, Vasilevskis EE, Egerod I, Bekker Mortensen C, Møller AM, Svenningsen H, Thomsen T
Cochrane Database Syst Rev 2018 Nov 23;11(11):CD009783. doi: 10.1002/14651858.CD009783.pub2. PMID: 30484283Free PMC Article
Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial.
Su X, Meng ZT, Wu XH, Cui F, Li HL, Wang DX, Zhu X, Zhu SN, Maze M, Ma D
Lancet 2016 Oct 15;388(10054):1893-1902. Epub 2016 Aug 16 doi: 10.1016/S0140-6736(16)30580-3. PMID: 27542303

Prognosis

Delirium in neurosurgery: a systematic review and meta-analysis.
Kappen PR, Kakar E, Dirven CMF, van der Jagt M, Klimek M, Osse RJ, Vincent APJE
Neurosurg Rev 2022 Feb;45(1):329-341. Epub 2021 Aug 16 doi: 10.1007/s10143-021-01619-w. PMID: 34396454Free PMC Article
Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients.
Burton JK, Craig LE, Yong SQ, Siddiqi N, Teale EA, Woodhouse R, Barugh AJ, Shepherd AM, Brunton A, Freeman SC, Sutton AJ, Quinn TJ
Cochrane Database Syst Rev 2021 Jul 19;7(7):CD013307. doi: 10.1002/14651858.CD013307.pub2. PMID: 34280303Free PMC Article
Delirium in hospitalized older adults.
Rieck KM, Pagali S, Miller DM
Hosp Pract (1995) 2020 Mar;48(sup1):3-16. Epub 2020 Jan 18 doi: 10.1080/21548331.2019.1709359. PMID: 31874064
Recent Advances in Preventing and Managing Postoperative Delirium.
Vlisides P, Avidan M
F1000Res 2019;8 Epub 2019 May 1 doi: 10.12688/f1000research.16780.1. PMID: 31105934Free PMC Article
Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial.
Su X, Meng ZT, Wu XH, Cui F, Li HL, Wang DX, Zhu X, Zhu SN, Maze M, Ma D
Lancet 2016 Oct 15;388(10054):1893-1902. Epub 2016 Aug 16 doi: 10.1016/S0140-6736(16)30580-3. PMID: 27542303

Clinical prediction guides

Delirium in neurosurgery: a systematic review and meta-analysis.
Kappen PR, Kakar E, Dirven CMF, van der Jagt M, Klimek M, Osse RJ, Vincent APJE
Neurosurg Rev 2022 Feb;45(1):329-341. Epub 2021 Aug 16 doi: 10.1007/s10143-021-01619-w. PMID: 34396454Free PMC Article
Effectiveness of multicomponent nonpharmacological delirium interventions: a meta-analysis.
Hshieh TT, Yue J, Oh E, Puelle M, Dowal S, Travison T, Inouye SK
JAMA Intern Med 2015 Apr;175(4):512-20. doi: 10.1001/jamainternmed.2014.7779. PMID: 25643002Free PMC Article
Seizures. Introduction.
Noachtar S, Schmidt D
Epilepsy Behav 2010 Oct;19(2):95. Epub 2010 Aug 7 doi: 10.1016/j.yebeh.2010.06.034. PMID: 20692874
Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).
Ely EW, Margolin R, Francis J, May L, Truman B, Dittus R, Speroff T, Gautam S, Bernard GR, Inouye SK
Crit Care Med 2001 Jul;29(7):1370-9. doi: 10.1097/00003246-200107000-00012. PMID: 11445689
Clarifying confusion: the confusion assessment method. A new method for detection of delirium.
Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI
Ann Intern Med 1990 Dec 15;113(12):941-8. doi: 10.7326/0003-4819-113-12-941. PMID: 2240918

Recent systematic reviews

The effect of the ABCDE/ABCDEF bundle on delirium, functional outcomes, and quality of life in critically ill patients: A systematic review and meta-analysis.
Sosnowski K, Lin F, Chaboyer W, Ranse K, Heffernan A, Mitchell M
Int J Nurs Stud 2023 Feb;138:104410. Epub 2022 Nov 29 doi: 10.1016/j.ijnurstu.2022.104410. PMID: 36577261
Effects of nonpharmacological interventions on sleep improvement and delirium prevention in critically ill patients: A systematic review and meta-analysis.
Kang J, Cho YS, Lee M, Yun S, Jeong YJ, Won YH, Hong J, Kim S
Aust Crit Care 2023 Jul;36(4):640-649. Epub 2022 Jun 17 doi: 10.1016/j.aucc.2022.04.006. PMID: 35718628
Pharmacologic treatment of delirium symptoms: A systematic review.
Sadlonova M, Duque L, Smith D, Madva EN, Amonoo HL, Vogelsang J, Staton SC, von Arnim CAF, Huffman JC, Celano CM
Gen Hosp Psychiatry 2022 Nov-Dec;79:60-75. Epub 2022 Oct 21 doi: 10.1016/j.genhosppsych.2022.10.010. PMID: 36375344
Delirium in neurosurgery: a systematic review and meta-analysis.
Kappen PR, Kakar E, Dirven CMF, van der Jagt M, Klimek M, Osse RJ, Vincent APJE
Neurosurg Rev 2022 Feb;45(1):329-341. Epub 2021 Aug 16 doi: 10.1007/s10143-021-01619-w. PMID: 34396454Free PMC Article
Delirium-related distress in the ICU: A qualitative meta-synthesis of patient and family perspectives and experiences.
Boehm LM, Jones AC, Selim AA, Virdun C, Garrard CF, Walden RL, Wesley Ely E, Hosie A
Int J Nurs Stud 2021 Oct;122:104030. Epub 2021 Jul 3 doi: 10.1016/j.ijnurstu.2021.104030. PMID: 34343884Free PMC Article

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