Timing and collateral history often hold the key to diagnosis

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John Michael Bostwick, MD

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Postgraduate Medicine:

Volume 108 No. 6


Clinical Focus

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DOI: 10.3810/pgm.2000.11.1288
Abstract: The confused patient sitting across from you presents a number of diagnostic challenges. The range of explanations for confusion is daunting, to say the least. It could be a symptom of delirium, depression, dementia, or sensory deprivation, and each of these conditions has numerous causes that could require substantial investigation. Dr Bostwick uses four scenarios involving a single patient, Mr S, to highlight the roles of physical and laboratory examination, collateral history, and clarification of time course in making sense of the syndrome of confusion. Bostwick JM. The many faces of confusion: timing and collateral history often hold the key to diagnosis. Postgrad Med 2000;108(6):60-72