Confusion

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KEY POINTS

• Confusion is unclear thinking. Confused people have trouble responding to questions, making choices, paying attention, and remembering things. Confusion may come on slowly or happen suddenly.
• The treatment depends on what is causing the confusion. Changing medicines or treating a medical problem may take care of the problem.
• Follow the full course of treatment prescribed by your healthcare provider, and make sure you know when to return for provider visits or tests.

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What is confusion?

Confusion is unclear thinking. Confused people have trouble responding correctly to questions. They also have trouble making choices, paying attention, and remembering things. Confusion may come on slowly over time, or it may happen suddenly.

Even if you are healthy, you can get confused if:

• You are given too much information or conflicting information
• You are not listening when something is said
• You are not paying attention to something happening around you

Usually, healthy people are no longer confused when they get better information or have more time to think through events or information.

Some especially serious forms of confusion are:

• Delirium, which is not knowing who or where you are. It is sudden and temporary and usually goes away with treatment of the problem causing it.
• Dementia, which is the gradual loss of the ability to think, remember, reason, and plan. It is usually long lasting, and often worsens over time.
• Psychosis, which is a loss of contact with reality. You cannot tell the difference between what is real and what is unreal. This may last for a short time or may be long term.

What is the cause?

Confusion can be caused by:

• Head injury or a tumor or disease in the brain
• Seizures
• Low level of oxygen such as in someone with a long term lung condition
• Illness in a person with existing neurological disease, such as a stroke
• Infections
• Fever
• Use of or withdrawal from drugs or alcohol
• Some medicines and natural remedies
• Very low blood sugar
• Problems with the balance of fluids and chemicals in your blood, such as potassium or sodium
• A lack of certain vitamins, especially in older adults
• Too little sleep (sleep deprivation)
• Sudden drop in body temperature (hypothermia)

What are the symptoms?

Signs and symptoms of confusion may include:

• Odd behavior or responses
• Not being able to concentrate or pay attention
• Not being able to remember things
• Sleepiness
• Not knowing who you are, where you are, or what day or year it is
• Trouble speaking or understanding what you see or hear
• Being restless or agitated

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Your provider will check for a medical illness or drug or alcohol problem that could cause the symptoms. You may have tests or scans to check for possible causes of the symptoms.

Your provider may also ask some questions to test your memory and thinking and to check for depression. Key questions to test for confusion are:

• Do you know where you are, the date, and the time?
• Do you know why you are here?
• Can you describe current events in the news or in your own life?

How is it treated?

The treatment depends on what is causing the confusion. For example, changing medicines or treating a medical problem may take care of the problem. If you have new or worse symptoms of confusion, you should see a healthcare provider and not be left alone.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.