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Disease relevance of Confusion


Psychiatry related information on Confusion


High impact information on Confusion

  • Phencyclidine hydrochloride (PCP) is a psychoactive drug that in small doses produces agitation, excitement, and disorientation, but in larger doses results in stupor, convulsions, coma, and death [11].
  • This occurred especially by an increase of second-order vasa vasorum and disorientation of normal vasa vasorum spatial pattern [12].
  • Overexpression of wild-type PDGFA, or inhibition of PDGFA both lead to randomized migration, disorientation of polarized mesodermal cells, decreased movement towards the animal pole, and reduced head formation and axis elongation [13].
  • Retinol has no effect and retinal has a small inhibitory effect but neither phenotypic transformation nor axial disorientation were observed [14].
  • Disorientation, memory impairment, and psychotic thought processes associated with the CNS lesions were not altered by the propranolol [15].

Chemical compound and disease context of Confusion

  • Initial levels of ACTH but not cortisol were significantly increased in patients with acute confusional state and significantly correlated with volume of brain lesion and neurological and functional outcome [16].
  • The myelographic contrast agent, metrizamide, causes a temporary confusional state in many patients [17].
  • We present three patients who, after long-term therapy with amantadine (4 to 18 years), experienced an acute delirium with confusion, disorientation, agitation, and paranoia on withdrawal [18].
  • 5-HIAA levels were mainly related positively to hostility and negatively to somatic concern, and MHPG positively to disorientation and negatively to emotional withdrawal and uncooperativeness [19].
  • In an effort to identify patients at risk for behavioral complications, we reviewed 92 patients undergoing ISA evaluation and found five with severe changes in affect and behavior following amobarbital injection, ranging from prolonged coma to an extended confusional state [20].

Biological context of Confusion


Anatomical context of Confusion


Gene context of Confusion

  • Mice deficient in Cdk5, p35, or both p35 and p39 display the hallmarks of disturbed cortical development, including cortical layer inversion, neuronal disorientation, and abnormal fiber infiltration [29].
  • In a multiple regression model, disorientation was associated with a low thyrotropin response to TRH (P = 0.02 and P = 0.04; 20 and 60 min after TRH, respectively) [30].
  • Two siblings had the clinical features of PCD and ciliary disorientation alone on repeated biopsies taken 10 yr apart [3].
  • X-ray fiber diffraction patterns of the R-type straight flagellar filament of Salmonella typhimurium SJW1655 strain showed layer-lines with an axial spacing of 1/437 A-1, which could be resolved only due to very small disorientation angles (< 2 degrees) of the filaments in oriented sol specimens [31].
  • Since CNS infection with B burgdorferi is usually accompanied by intrathecal synthesis of specific antibody, we studied CSF in 73 patients referred for presumed CNS Lyme, manifested primarily as this confusional state [32].

Analytical, diagnostic and therapeutic context of Confusion


  1. Ciprofloxacin-induced complex partial status epilepticus manifesting as an acute confusional state. Isaacson, S.H., Carr, J., Rowan, A.J. Neurology (1993) [Pubmed]
  2. Abnormalities at different levels of the hypothalamic-pituitary-adrenocortical axis early after stroke. Olsson, T., Marklund, N., Gustafson, Y., Näsman, B. Stroke (1992) [Pubmed]
  3. Ciliary disorientation alone as a cause of primary ciliary dyskinesia syndrome. Rayner, C.F., Rutman, A., Dewar, A., Greenstone, M.A., Cole, P.J., Wilson, R. Am. J. Respir. Crit. Care Med. (1996) [Pubmed]
  4. Spatial disorientation in Parkinson's disease: no effect of levodopa substitution therapy. Hovestadt, A., De Jong, G.J., Meerwaldt, J.D. Neurology (1988) [Pubmed]
  5. Ciliary disorientation in patients with chronic upper respiratory tract inflammation. Rayner, C.F., Rutman, A., Dewar, A., Cole, P.J., Wilson, R. Am. J. Respir. Crit. Care Med. (1995) [Pubmed]
  6. "Doom anxiety" and delirium in lidocaine toxicity. Saravay, S.M., Marke, J., Steinberg, M.D., Rabiner, C.J. The American journal of psychiatry. (1987) [Pubmed]
  7. Kluver-Bucy syndrome in Pick disease: clinical and pathologic correlations. Cummings, J.L., Duchen, L.W. Neurology (1981) [Pubmed]
  8. Problems and pitfalls in the use of benzodiazepines in the elderly. Kruse, W.H. Drug safety : an international journal of medical toxicology and drug experience. (1990) [Pubmed]
  9. Electroencephalography. Binnie, C.D., Prior, P.F. J. Neurol. Neurosurg. Psychiatr. (1994) [Pubmed]
  10. Memory loss, confusion, and disorientation in an elderly woman taking meclizine. Molloy, D.W. Journal of the American Geriatrics Society. (1987) [Pubmed]
  11. Phencyclidine abuse mimicking head injury. Corales, R.L., Maull, K.I., Becker, D.P. JAMA (1980) [Pubmed]
  12. Enhanced coronary vasa vasorum neovascularization in experimental hypercholesterolemia. Kwon, H.M., Sangiorgi, G., Ritman, E.L., McKenna, C., Holmes, D.R., Schwartz, R.S., Lerman, A. J. Clin. Invest. (1998) [Pubmed]
  13. Guidance of mesoderm cell migration in the Xenopus gastrula requires PDGF signaling. Nagel, M., Tahinci, E., Symes, K., Winklbauer, R. Development (2004) [Pubmed]
  14. Mechanism of skin morphogenesis. II. Retinoic acid modulates axis orientation and phenotypes of skin appendages. Chuong, C.M., Ting, S.A., Widelitz, R.B., Lee, Y.S. Development (1992) [Pubmed]
  15. Propranolol in the treatment of rage and violent behavior in patients with chronic brain syndromes. Yudofsky, S., Williams, D., Gorman, J. The American journal of psychiatry. (1981) [Pubmed]
  16. Pattern of activation of the hypothalamic-pituitary-adrenal axis in acute stroke. Relation to acute confusional state, extent of brain damage, and clinical outcome. Fassbender, K., Schmidt, R., Mössner, R., Daffertshofer, M., Hennerici, M. Stroke (1994) [Pubmed]
  17. Metrizamide inhibits human brain hexokinase. Bertoni, J.M. Neurology (1982) [Pubmed]
  18. Acute delirium after withdrawal of amantadine in Parkinson's disease. Factor, S.A., Molho, E.S., Brown, D.L. Neurology (1998) [Pubmed]
  19. Biogenic amine metabolites in plasma of drug-naive schizophrenic patients: associations with symptomatology. Markianos, M., Botsis, A., Arvanitis, Y. Biol. Psychiatry (1992) [Pubmed]
  20. Severe behavioral complications following intracarotid sodium amobarbital injection: implications for hemispheric asymmetry of emotion. Lee, G.P., Loring, D.W., Meador, K.J., Flanigin, H.F., Brooks, B.S. Neurology (1988) [Pubmed]
  21. Urinary free cortisol excretion shortly after ischaemic stroke. Olsson, T. J. Intern. Med. (1990) [Pubmed]
  22. Predictors of hospitalization in male Marine Corps recruits with exertional heat illness. Hakre, S., Gardner, J.W., Kark, J.A., Wenger, C.B. Military medicine. (2004) [Pubmed]
  23. The secondary nature of ciliary (dis)orientation in secondary and primary ciliary dyskinesia. Jorissen, M., Willems, T. Acta Otolaryngol. (2004) [Pubmed]
  24. "Organic brain syndrome" secondary to 5-fluorouracil toxicity. Lynch, H.T., Droszcz, C.P., Albano, W.A., Lynch, J.F. Dis. Colon Rectum (1981) [Pubmed]
  25. Full-term and prematurely ruptured fetal membranes. An ultrastructural study. Bou-Resli, M.N., Al-Zaid, N.S., Ibrahim, M.E. Cell Tissue Res. (1981) [Pubmed]
  26. Second-line chemotherapy with cisplatin-ifosfamide in patients with ovarian cancer previously treated with carboplatin-cyclophosphamide. Polyzos, A., Tsavaris, N., Kosmas, C., Petrikos, G., Giannikos, L., Kalahanis, N., Papadopoulos, O., Christodoulou, K., Giannakopoulos, K., Veslemes, M., Katsilambros, N. Journal of chemotherapy (Florence, Italy) (1999) [Pubmed]
  27. Celecoxib-induced methemoglobinemia. Kaushik, P., Zuckerman, S.J., Campo, N.J., Banda, V.R., Hayes, S.D., Kaushik, R. The Annals of pharmacotherapy. (2004) [Pubmed]
  28. Chlorpyrifos elicits mitotic abnormalities and apoptosis in neuroepithelium of cultured rat embryos. Roy, T.S., Andrews, J.E., Seidler, F.J., Slotkin, T.A. Teratology (1998) [Pubmed]
  29. Control of cortical neuron migration and layering: cell and non cell-autonomous effects of p35. Hammond, V., Tsai, L.H., Tan, S.S. J. Neurosci. (2004) [Pubmed]
  30. Pituitary-thyroid axis, prolactin and growth hormone in patients with acute stroke. Olsson, T., Asplund, K., Hägg, E. J. Intern. Med. (1990) [Pubmed]
  31. Radial mass analysis of the flagellar filament of Salmonella: implications for the subunit folding. Yamashita, I., Vonderviszt, F., Mimori, Y., Suzuki, H., Oosawa, K., Namba, K. J. Mol. Biol. (1995) [Pubmed]
  32. Lyme borreliosis-associated encephalopathy. Halperin, J.J., Krupp, L.B., Golightly, M.G., Volkman, D.J. Neurology (1990) [Pubmed]
  33. Lumbar myelography with iohexol and metrizamide: a comparative multicenter prospective study. Kieffer, S.A., Binet, E.F., Davis, D.O., Gabrielsen, T.O., Kido, D.K., Latchaw, R.E., Turski, P.A., Shaw, D.D. Radiology. (1984) [Pubmed]
  34. Prolonged postoperative disorientation after methylene blue infusion during parathyroidectomy. Siebert, C., Kroeber, S., Lutter, N. Anesth. Analg. (2005) [Pubmed]
  35. Cortical blindness during chemotherapy: clinical, CT, and MR correlations. Heran, F., Defer, G., Brugieres, P., Brenot, F., Gaston, A., Degos, J.D. Journal of computer assisted tomography. (1990) [Pubmed]
  36. Cognitive deterioration associated with focal cortical dysplasia. Oki, J., Miyamoto, A., Takahashi, S., Takei, H. Pediatric neurology. (1999) [Pubmed]
  37. Triphasic waves and cerebral tumors. Aguglia, U., Gambardella, A., Oliveri, R.L., Lavano, A., Camerlingo, R., Quattrone, A. Eur. Neurol. (1990) [Pubmed]
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