J Neuropsychiatry Clin Neurosci 1989; 1:283-290
Copyright © 1989 by American Neuropsychiatric Association
Delirium: a subcortical phenomenon?
PT Trzepacz, RJ Sclabassi and DH Van Thiel
University of Pittsburgh School of Medicine, Pennsylvania.
Evoked potentials of 23 patients with chronic liver disease and delirium
were compared with those of matched controls without delirium. Delirious
subjects had significantly worse scores on the Mini-Mental State Exam and
Trail Making Tests. Mean peak activity from computerized spectral analysis
of the EEG was lower in delirious subjects than in nondelirious subjects
(7.5 +/- 3.8 cycles per second (cps) and 9.5 +/- 3.2 cps, respectively).
Mean auditory brainstem evoked potentials were abnormal in both groups,
with delirious subjects showing a bimodal distribution of latency values
and a greater proportion of abnormal values. Somatosensory evoked
potentials were abnormal for delirious patients and normal for controls,
and the differences were significant. The data suggest that the underlying
pathophysiology of delirium may lie, at least in part, at the subcortical
level.
