The many faces of confusion - Timing and collateral history often hold thekey to diagnosis

The confused patient sitting across from you presents a number of diagnosti c challenges. The range of explanations for confusion is daunting, to say t he least. It could be a symptom of delirium, depression, dementia, or senso ry deprivation, and each of these conditions has numerous causes that could require substantial investigation, Dr Bostwick uses four scenarios involvi ng a single patient, Mr S, to highlight the roles of physical and laborator y examination, collateral history, and clarification of time course in maki ng sense of the syndrome of confusion.