Acute confusional state in paediatric age - Case Report

Introduction Acute confusional state (ACS) or delirium is an acute neuropsychiatric syndrome due to underlying organic pathological process. Despite its high prevalence, can present a diagnostic challenge, particularly in paediatric patients. ACS be defined as sudden impairment of mental status previously healthy child. The varies; it may global and severe very specific mild, such short-term memory “transient amnesia.” most common causes the population are fever, drugs, traumatic brain injury (TBI), infection inflammation nervous system. Traumatic usually associated with some consciousness, although recovery vary depending on severity trauma. Objectives aim this work revisit approach management population. Methods Case report state, secondary TBI non-systematic review literature. Results A 17-year-old female was admitted emergency department after being injured car accident. She drowsy but easily awakened. conscious partially oriented time space. had amnesia for episode. spoke fluently coherently hesitant regarding hours before accident, which probably impairment. exhibited sporadic hetero-aggressive behavior during first few examination. no other thought perceptual disorders. Head CT scan showed “a thin collection blood from frontal interhemispheric area discrete subarachnoid sulcal frontobasal hemorrhage, significant changes.” Toxicology tests were positive THC, cocaine, MDMD negative alcohol. forensic medical examination required. After 48 vigilance improvement, she discharged booked re-evaluation within week. At second evaluation, her mother described change usual disorientation, drowsiness, difficulty managing daily life, persecutory delusions physicians agitated. child adolescent psychiatric hospital further evaluation stabilization. 72 inpatient stay, fully recovered, receiving low-dose risperidone daily. diagnosis another condition acute, hyperactive. Since discharge, symptoms have not recurred even discontinuation antipsychotic medication. Conclusions Clinically, divided into hypoactive, hyperactive, mixed level activity. Hyperactive forms manifest varying degrees psychomotor agitation. With case report, we’d like raise awareness so that it’s diagnosed treated correctly timely manner. Disclosure Interest None Declared