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

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.