Metabolic causes of delirium can come in form of any metabolic disorder, which changes the brain metabolism and can potentially tip the balance changing a normal functioning brain into a delirium.
Anoxia (= the lack of oxygen) can after 5 to 7 minutes lead to permanent damage to the brain cells. If there is one area of the brain where there is a narrowed artery, one segment of the brain has poor circulation meaning that there is a lack of oxygen and this can lead to a delirium.
Electrolyte imbalance such as hyperkalemia (too much potassium), hypokalemia (too little potassium), metabolic acidosis or hypercalcemia from hyperparathyroidism can lead to delirium.
With diabetes the same patient may inject too much insulin and get hypoglycemia, which can cause a delirium. However, the same patient may forget to take insulin a few days in a row and develop a ketoacidosis where high blood sugars and toxic organic ketoacids push the brain into a delirium. With thyroid disease there is also a situation where both hypothyroidism and hyperthyroidism will cause delirium.
Finally, in end stage liver cirrhosis the metabolism is severely deranged and ammonia does not get detoxified causing a delirium.
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