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Baclofen, sold under the brand name Lioresal among others, is a medication used to treat muscle spasticity, such as from a spinal cord injury or multiple sclerosis. [8] [9] It may also be used for hiccups and muscle spasms near the end of life, [9] and off-label to treat alcohol use disorder [10] [11] or opioid withdrawal symptoms. [12]
POCD is common in adult patients of all ages at hospital discharge after major noncardiac surgery, but only the elderly (aged 60 years or older) are at significant risk for long-term cognitive problems. Patients with POCD are at an increased risk of death in the first year after surgery. [9]
When the steroid treatment ended after a year, the patent's confusion and disorganized appearance stopped immediately. Within several weeks, testing showed strong improvement in almost all cognitive functions. His doctors were surprised at the improvement, since the results were inconsistent with a diagnosis of dementia or Alzheimer's.
Here's how to distinguish "sundowning"—agitation or confusion later in the day in dementia patients—from typical aging, from doctors who treat older adults.
A baclofen pump has been used to treat patients of all ages exhibiting muscle spasticity along with dystonia. The pump delivers baclofen via a catheter to the thecal space surrounding the spinal cord. The pump itself is placed in the abdomen. It can be refilled periodically by access through the skin. Baclofen can also be taken in tablet form [40]
Treatment includes stopping the neuroleptic medication if possible (although this may temporarily worsen symptoms) or switching to clozapine. [1] Other medications such as valbenazine, tetrabenazine, or botulinum toxin may be used to lessen the symptoms. [1] [4] With treatment, some see a resolution of symptoms, while others do not. [1]
Delirium (formerly acute confusional state, an ambiguous term that is now discouraged) [1] is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days.
Fifth, some older people may have atypical symptoms — for example, instead of having a high fever and cough, they have worsening confusion or diarrhea. This could lead to a delay in diagnosis ...