Delirium can manifest neuropsychiatric symptoms that mimic psychological disorders, leading to potential misdiagnoses. Specifically, hyperactive delirium presents symptoms that resemble mania or schizophrenia, while hypoactive delirium presents symptoms resembling severe depression. To distinguish delirium from a psychological disorder, healthcare professionals should determine whether the symptoms appear suddenly, fluctuate inconsistently, and are accompanied by an altered level of consciousness.

Misdiagnosing Delirium as a Psychological Disorder

Delirium is a state of acute confusion, caused due to deteriorating baseline mental functioning. It is characterised by disturbances in attention, consciousness, and cognition, along with neurological defects which may include psychomotor disturbances, impaired sleep-wake cycle, emotional disturbances, and perceptual disturbances. Causes of delirium include disease in the brain, side effect of medication, withdrawal from drugs, over-consumption of alcohol, usage of hallucinogenic deliriants. 

State University of New York at Buffalo

Nervous system diseases affect the brain, spinal cord and nerves. These include structural, biochemical and electrical damages. Below are a few lists of diseases covered in 1Cademy:
- Guillain–Barré syndrome (GBS)
- Encephalopathy
- Anosmia
- Seizures
- Stroke
- Paralysis
- Ageusia

Neurological Diseases

Wikipedia

Guillain-Barré syndrome occurs when the immune system attacks the peripheral nervous system, causing damage to the nerves. It is characterized by muscle weakness, and in some cases, paralysis. 

Guillain-Barré Syndrome (GBS)

Encephalopathy is an umbrella term for damages and diseases to the brain. They include, but are not limited, to the following:
- Ischemic Stroke
- Ophthalmoparesis

Encephalopathy 

Even in the absence of typical respiratory symptoms such as fever, cough, and shortness of breath, various patients diagnosed with COVID-19 have presented neurological symptoms, such as:

- acute cerebrovascular diseases

- impaired consciousness

-  skeletal muscle injury

- encephalopathy (symptoms: ischemic stroke)

- loss of smell (anosmia) and taste (ageusia)

- stroke

- cranial nerve deficits

- delirium

- meningitis

- paralysis

- seizures

- neuroinflammatory syndromes

- high pressure CSF

- muscle stiffness

The list below includes less-common neurological symptoms of COVID-19:
- Guillain–Barré syndrome (GBS)
- Multisystem Inflammatory Syndrome in Children (MIS-C)

Neurological symptoms Presented in COVID-19 Patients

Anosmia, is the temporary or permanent loss of smell. It is also called smell blindness. It can be caused due to inflammation of the nasal passage or due to brain damage. Anosmia caused due to brain damage is permanent and can not be treated. While the loss of smell due to inflammation can be treated with glucocorticoids. This neurological disorder can have a myriad of harmful effects ranging from an increase in gas leak incidents to loss of appetite, as the person is unable to taste food properly.
Anosmia is one of the primary symptom of COVID-19. Around 80% of infected patients face the loss of smell at some point during the infection. 


Anosmia

A seizure is characterised by uncontrolled shaking followed by unconsciousness. It may also lead to loss of bladder control. Seizures are caused due to abnormal excessive or synchronous activity in the brain. Commonly called epileptic seizures, they may take around 2 minutes to subside. They can be caused due to hypoxic ischemic encephalopathy, central nervous system infections, trauma, congenital CNS abnormalities, metabolic disorders, sleep deprivation, brain tumor etc. 

Seizures

Stroke is characterised by the loss of movement or the ability to feel one part of the body, loss of vision, problems understanding or speaking, dizziness. It is caused due to poor blood flow to the brain, which cause faulty functioning. There may be a poor blood flow due to internal bleeding (hemorrhagic stroke) or due to lack of blood flow (ischemic stroke). The symptoms of a stroke may be permanent. 

Stroke

Paralysis is caused by damage to the nervous system and is characterised as the loss of motor function in one or more muscles. It can also accompany loss of sensation if there is a damage to the sensory part too. Apart from nervous system injuries it can be caused due to certain drugs, stroke, trauma, ALS and other neurological diseases. 

Paralysis

Ageusia is characterised as the loss of taste function of the tongue, particularly the loss to detect sweet, salty, bitter and sour flavor. Often times confused with anosmia, it is one of the symptoms of COVID-19. It may be caused due to head injury, upper respiratory tract infection, exposure to toxic substances, medicines etc. 

Ageusia

Delirium

Neurodegenerative diseases refers to neurological diseases caused by neuronal death or deterioration due to many factors, including protein aggregation/misfolding, apoptosis, and mitochondrial dysfunction. 

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