acute brain syndrome acute brain failure acute confusional

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譫妄之同義詞 • • • • 急性大腦徵候群(acute brain syndrome) 急性腦衰竭(acute brain failure) 急性惑亂狀態(acute confusional state)

譫妄之同義詞 • • • • 急性大腦徵候群(acute brain syndrome) 急性腦衰竭(acute brain failure) 急性惑亂狀態(acute confusional state) 急性器質性精神病(acute organic psychosis) 急性外生性反應症(acute exogenous reaction) 急性可逆性精神病(acute reversible psychosis) 急性癡呆症(acute dementia) 可逆性癡呆症(reversible dementia) 中毒性精神病(toxic psychosis) 傳染性-消耗性精神病(infective-exhaustive psychosis) 新陳代謝性腦病(metabolic encephalopathy) 器質性大腦徵候群(organic brain syndrome) ICU 精神病(ICU psychosis) 可逆性大腦功能失調(reversible cerebral dysfunction) 可逆性認知功能失調(reversible cognitive dysfunction)

DSM-IV-TR 譫妄之診斷條件 A. 意識障礙以致難以集中注意力 Disturbance of consciousness (i. e. , reduced clarity of awareness

DSM-IV-TR 譫妄之診斷條件 A. 意識障礙以致難以集中注意力 Disturbance of consciousness (i. e. , reduced clarity of awareness about the environment) with reduced ability to focus, sustain, or shift attention. B. 認知及感知能力受損(非原有失智症所致) A change in cognition (e. g. , memory deficit, disorientation, language disturbance) or development of a perceptual disturbance that is not better accounted for by a preexisting, established, or evolving dementia. C. 急性發作(數小時至數日)且其狀態常波動 The disturbance develops over a short period of time (usually hours to days) and tends to fluctuate during the course of a day. D. 因傷病或生理失衡所致 Evidence from the history, physical examination, or laboratory findings indicate that the disturbance is caused by direct physiologic consequences of a general medical condition. Adopted from. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, D. C. , American Psychiatric Association, 2000: 143. Copyright 2000, American Psychiatric Association. 前驅症狀 請說出譫妄和精神病/失智異同之處

常見引發譫妄之藥物 抗乙醯膽鹼藥物 (artane, akineton, antihistamine, antispasmodics, tricyclic antidepressants, antipsychotics) 麻醉性止痛藥 (meperidine) 鎮定劑及安眠藥 類固醇 中樞降血壓藥物(methyldopa,

常見引發譫妄之藥物 抗乙醯膽鹼藥物 (artane, akineton, antihistamine, antispasmodics, tricyclic antidepressants, antipsychotics) 麻醉性止痛藥 (meperidine) 鎮定劑及安眠藥 類固醇 中樞降血壓藥物(methyldopa, reserpine) 抗巴金森氏症藥物 (levodopa) 交感神經促進劑(ritalin, pseudoephedrine, dextroamphetamine) 其他 (aminophylline, insulin, thyroxine)

進一步之檢查 • • Cultures of blood, urine, sputum, stool Brain CT scan / MR

進一步之檢查 • • Cultures of blood, urine, sputum, stool Brain CT scan / MR imaging f. T 4, TSH STS (梅毒篩檢) Cortisol level Lumbar puncture EEG 絕大部份引發譫妄的病因 在病程初期皆具可逆性。