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White Paper Report on Excited Delirium Syndrome

NCJ Number
Date Published
September 2009
22 pages
This is the report of the Excited Delirium (ExDS) Task Force established by the American College of Emergency Physicians (ACEP) to determine whether such a syndrome is a disease entity, the characteristics that help identify the presentation and risk for death of those having the syndrome, as well current and emerging methods of control and treatment.
It is the consensus of the Task Force that ExDS is a unique syndrome which may be identified by the presence of a distinctive group of clinical and behavioral characteristics that can be recognized in the pre-mortem state. ExDS, while potentially fatal, may be amenable to early therapeutic intervention in some cases. The Task Force debated the merits of renaming the syndrome in a medically more descriptive way; however, it decided that the literature and general understanding of the term in the health care and law enforcement fields favored retention of the traditionally understood word for research and clinical purposes. Despite increased research, the exact pathophysiology of ExDS remains unidentified. Currently, physicians and other medical and non-medical personnel involved in personal interactions with these patients do not have a definitive diagnostic "test" for ExDS. It must be identified by its clinical features. This fact makes it difficult to determine the true incidence of ExDS. In this paper, the Task Force provides a review of the history and epidemiology of ExDS, clinical perspectives, and a discussion of its potential pathophysiology, diagnostic characteristics, differential diagnoses, and clinical treatment. Ultimately, the goals are to raise awareness of the existence of this syndrome to medical and public entities responsible for public health and safety. 5 tables and 58 references