Extended Delirium Treated as Psychosis

Abstract

Delirium is a commonly seen neuropsychiatric disorder that may extend over time, lasting for more than 60 days, thus increasing the risk of cognitive and behavioral outcomes in patients. Electroconvulsive therapy (ECT) is one of the treatment modalities for behavior control but may be associated with rare complications such as tardive seizure, convulsive status epilepticus, and prolonged postictal confusion. We report a case of acute psychosis who was given consecutive 2 ECTs, after which she developed probable tardive seizure in the recovery period, followed by status epilepticus and extended delirium lasting for more than 2½ months, but was misdiagnosed as psychosis and treated with several antipsychotic medications. As there was no improvement in her condition, she was then transferred to a tertiary center for further management.

Keywords

• extended delirium
• piracetam
• psychosis
• status epilepticus
• tardive seizure