Delirium is a common and severe neuropsychiatric syndrome characterized by acute changes in attention, cognition, and consciousness. It can present in different clinical forms, including hyperactive and hypoactive delirium. Hyperactive delirium is characterized by increased psychomotor activity, agitation, and disruptive behavior, while hypoactive delirium is characterized by reduced psychomotor activity, somnolence, and decreased responsiveness. The diagnosis of hyperactive and hypoactive delirium involves a comprehensive evaluation of medical history, physical examination, and laboratory tests to identify underlying causes and exclude other conditions. Prompt recognition and accurate diagnosis are crucial for appropriate management and treatment. The management of hyperactive and hypoactive delirium aims at addressing the underlying etiology, ensuring patient safety, and alleviating distressing symptoms. Treatment strategies include the optimization of medical conditions, discontinuation or adjustment of offending medications, and supportive care. Pharmacological interventions, such as the use of sedative medications for hyperactive delirium or stimulant agents for hypoactive delirium, may be considered when necessary. Multidisciplinary collaboration involving healthcare professionals, including physicians, nurses, and therapists, is essential for the comprehensive care of patients with hyperactive and hypoactive delirium. In conclusion, hyperactive and hypoactive delirium are distinct clinical manifestations of an acute confusional state. Their identification, diagnosis, and management require a multidimensional approach to address the underlying causes and alleviate symptoms. Early recognition and appropriate interventions are crucial for improving patient outcomes and enhancing their overall well-being.
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