The Immunology of Delirium

er levels of pro-inflammatory cytokines and cortisol were identified in plasma and cerebrospinal fluid. However, to date it has not been clarified how peripheral inflammatory or endocrine biomarkers can reflect the likelihood or sever-ity of delirium symptoms. In the future, a better understand-ing of the interaction between the brain and peripheral or-gans and the exact mechanism by which systemic inflamma-tion can lead to delirium, will allow the development of new therapeutic agents. © 2014 S. Karger AG, Basel Conceptual Overview Delirium refers to a cluster of cognitive, emotional and behavioural symptoms developing rapidly in the context of an underlying general medical condition and/or sub-stance use considered to be aetiologically related to the symptoms [1]. In addition to the core features of dis-turbed consciousness with inattention, delirium mani-fests with a global impairment in cognitive function (such as memory deficit, disorientation or language distur-bance) and/or with perceptual disturbances which are not better accounted for by a pre-existing dementia [1]. Ad-ditionally, a range of neuropsychiatric symptoms are al-most invariably present, including sleep-wake distur-bance, lability of affect, delusions and motor disturbanc-es. Delirium has typically an acute onset and symptoms fluctuate over the course of the day [2]. This syndrome is particularly common in elderly subjects with acute medi