Pro-inflammatory cytokines such as interleukins and tumor necrosis factor alpha also may have a role in the pathogenesis of delirium. Cytokine activation may account for delirium (particularly hyperactive forms of the disturbance) in situations such as sepsis (where mental changes may actually precede fever), cardiopulmonary bypass and acute hip fracture. Thought content disturbances of delirium entails themes from the immediate environment and circumstances, hallucinations used to be frequently visual rather than auditory and formal thought disorder typically comprised poverty of thinking and illogicality.
The permeability of blood brain barrier is impaired by ageing and dementia, which may predispose the patient to delirium. The major neurotransmitter hypothesized to be involved in delirium is acetylcholine, which is decreased in the brain.
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Last date updated on July, 2014