Psychiatria pre prax 5/2008

HOW TO ESTABLISH AND TREAT A CAUSE OF PATIENT DESORIENTATION IN HOSPITAL DEPARTMENTS FOR SOMATIC DISEASES?

Episodes of desorientation are very serious complications during hospital therapy of somatic diseases. Desorientation may reach different grades (sometimes only by place and time, sometimes also by person). The severity of desorientation may vary even in short time intervals. The most frequent cause of orientation disorders are deliria. These states are frequently caused or triggered by somatic diseases for which the patient is treated or by unrecognised somatic disease. Amnestic syndromes are based on a block of consolidation of episodic memory. In dementia, the cause of desorientation is also amnestic syndrome, but associated deliria may contribute to its cause. A rare cause of desorientation may be postictal state in epilepsy (nowadays classified as delirium). The basic therapy of orientation disorders consists of removal of its causes or precipitating factors. It is necessary to keep correct hydration, nutrition, and metabolic state of patients with somatic diseases.

Keywords: amnestic syndrome, deliria, dementia, postictal state, orientation