Why do people become confused, agitated and violent and then suddenly drop dead? A new case report suggests so-called excited delirium may be the missing piece of the puzzle.
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After arresting a 30-year-old man who they said was violently assaulting several individuals, police brought him to the emergency room rather than to the station because of his behavior, including confusion, agitation and nonsensical speech.
Police reports indicated the man was "acting very strange," "agitated," "babbling" and "yelling and sweating profusely," according to a case report published online June 4 in the Journal of Emergency Medicine. Essentially, the man was in a state of what doctors call "excited delirium."
The attending physician at the Wake Forest Baptist Medical Center in Winston-Salem, N.C., found that in addition to delirium, the man was suffering from Long QT syndrome, a heart-rhythm disorder that can cause fast, erratic heartbeats. In some cases the erratic heartbeats persist so long they lead to sudden death, according to the Mayo Clinic.
The man was successfully treated with fluids and sodium bicarbonate for his symptoms.
As such, the police may have saved the man's life, as well as shed some light on a weird phenomenon in which individuals die suddenly after a display of confusion and delirium (and often after being subdued by police, making the headlines). Perhaps some of these deaths are caused by the abnormal heart condition, compounded by excited delirium, Dr. William Bozeman, an emergency medicine physician at Wake Forest Baptist, said in a statement. [7 Weirdest Medical Conditions]
"Why do people become confused, agitated and violent and then suddenly drop dead? That's the big question," said Bozeman. "This has been seen for well over a century, but we don't have a clear answer. It may be an important link to investigate with future research."
Excited delirium, he said, could actually trigger Long QT syndrome. "The amount of adrenaline in the body can affect Long QT syndrome. In some people electrical abnormalities are there all the time, while in others they are transient."
Excited delirium seems to be most commonly caused by drug use. (That may have been the case in North Carolina, as the man admitted marijuana use, though he denied using other illicit drugs.) Psychiatric problems and/or medications represent the second most common cause, followed by various others.
Excited delirium is "a clinical syndrome that may have a variety of causes, but they all present in a similar way: with agitation, confusion or delirium, violence, and superhuman-like strength," Bozeman said in a statement.
The research was funded by the National Institute of Justice.