Toxic-Metabolic Encephalopathy

Toxic-metabolic encephalopathy, synonymous with delirium or altered mental status, is commonly seen in hospital settings. It is an acute confusional state that can occur in a vulnerable person from a variety of insults. The presence of delirium is associated with increased mortality, cognitive impairment, and institutionalization. Primary prevention and treatment of underlying medical disorder are imperative to reducing cases of delirium. In this article, the authors review the underlying pathophysiology, outline key features in diagnosis, and discuss prevention and management.