ditandai dengan fluktuasi antara subtipe hiperaktif dan hipoaktif. Gleason, 2003 Trauma kapitis termasuk delirium hiperaktif secara motorik. Trzepacz, 1994
II.2.8. Kriteria diagnostik
Diagnosis delirium merupakan diagnosis klinis. Perolehan riwayat penyakit yang cermat merupakan hal yang sangat mendasar. Pemeriksaan fisik yang teliti
dan komplet mencakup pemeriksaan status mental sangat diperlukan. Alagiakrishnan dan Blanchette, 2005
DSM-IV-TR mengelompokkan kriteria diagnostik untuk setiap tipe delirium yaitu : delirium karena kondisi medis umum Tabel 4, delirium intoksikasi zat,
delirium karena putus zat, delirium karena etiologi yang multipel, dan delirium yang tidak ditentukan untuk delirium dengan penyebab yang tidak terdaftar.
Bagaimanapun sindroma delirium tetap sama, tanpa memperhatikan penyebab. cit
. Sadock dan Sadock, 2003
Tabel 4. DSM-IV-TR Diagnostic Criteria for Delirium Due to General Medical
Condition
A. Disturbance of consciousness i.e., reduced clarity of awareness of the environment
with reduced ability to focus, sustain, or shift attention B.
A change in cognition such as memory deficit, disorientation, language disturbance or the development of a perceptual disturbance that is not better accounted for by a
preexisting, established, or evolving dementia C.
The disturbance develops over a short period of time usually hours to days and tends to fluctuate during the course of the day
D. There is evidence from the history, physical examination, or laboratory findings that
the disturbance is caused by the direct physiological consequences of a general medical condition
Kiki Mohammad Iqbal: Hubungan Skore Cognitive Test For Delirium CTD Dengan Lamanya Masa Rawat Inap Penderita Trauma Kapitis Sedang-Berat Di Rumah Sakit, 2008.
Coding note : If delirium is superimposed on a preexisting vascular dementia, indicate the delirium by coding vascular dementia, with delirium.
Coding note : Include the name of the general medical condition on Axis I, e.g., Delirium due to hepatic encephalopathy; also code the general medical condition on Axis III.
Dikutip dari : Sadock, B.J. and Sadock, V.A. 2003. Kaplan Sadock’s Synopsis of Psychiatry. 9th ed. Lippincott Williams Wilkins. Philadelphia.
Untuk kesempurnaan fenomenologi delirium tercermin pada kriteria diagnostik
International Classification of Diseases ICD 10. Tabel 5
cit . Burns
dkk, 2004
Tabel 5. ICD 10 diagnostic criteria for delirium
For a definite diagnosis, symptoms, mild or severe, should be present in each of the following areas :
a Impairment of consciousness and attention ranging from clouding to coma; reduced
ability to direct, focus, sustain and shift attention b
Global disturbance of cognition perceptual distortions, illusions and hallucinations – most often visual; impairment of abstract thinking and comprehension, with or
without transient delusions, but typically with some degree of incoherence; impairment of immediate recall and of recent memory, but with relatively intact
remote memory; disorientation for time as well as in more severe cases for place and person
c Psychomotor disturbances hypo – or hyperactivity and unpredictable shifts from one
to the other; increased reaction time; increased or decreased flow of speech; enhanced startle reaction
d Disturbance of the sleep wake cycle insomnia or, in more severe cases, total sleep
loss or reversal of the sleep wake cycle; daytime drowsiness; nocturnal worsening of symptoms; disturbing dreams or nightmares, which may continue as hallucinations
after awakening e
Emotional disturbances, foe example, depression, anxiety or fear, irritability, euphoria, apathy or wondering, perplexity
Dikutip dari : Burns, A.; Gallagley, A. and Byrne, J. 2004. Delirium. J Neurol Neurosurg Psychiatry. 75:362-367.
Kiki Mohammad Iqbal: Hubungan Skore Cognitive Test For Delirium CTD Dengan Lamanya Masa Rawat Inap Penderita Trauma Kapitis Sedang-Berat Di Rumah Sakit, 2008.
Lebih dari 20 tahun telah banyak dijumpai perkembangan dalam neuropsikologi, salah satunya yaitu perkembangan penggunaan
tool untuk
mengidentifikasi, mendiagnosis dan menilai profil gejala delirium. Sejumlah instrumen skrining untuk gangguan kognitif telah tersedia, namun untuk lebih
reliabel membedakan antara delirium dan demensia membutuhkan data onset dan perjalanan gejala yang timbul. Meagher, 2001
II.2.9. Prognosis
