Delirium is a serious and common acute neuropsychiatric syndrome in the elderly, characterized by disturbances in consciousness, memory, orientation, perception, thought, and behaviour, fluctuating course and acute onset. The etiologies of delirium are multifactorial and diverse and often reflect the consequences of acute medical conditions, disease complications or drug intoxication. Delirium can have a variable presentation and need instruments that can improve detection and diagnosis. Understanding the aetiology, assessment, and systematic detection and treatment programs appear to be beneficial for the elderly. We present the case of female 70 years old with altered mental status after her family noted a change in the patient's behaviour. For the past few days, the patient's appetite waned, and she became agitated. Previously the patient had experienced diarrhoea for several days. After a comprehensive evaluation, the patient was diagnosed with hyperactive delirium due to electrolyte disturbances (hyponatremia and hypokalemia). Treatment is done by improving sodium and potassium levels and administering haloperidol. We discuss the presentation and management of this patient and review the treatment options of hyperactive delirium due to hyponatremia and hypokalemia.
Key words: delirium, treatment, hyponatremia, elderly
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