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Neurology 2001;57:551-553
© 2001 American Academy of Neurology
Brief Communications

Delirium from nicotine withdrawal in neuro-ICU patients

S. A. Mayer, MD;, J. Y. Chong, MD;, E. Ridgway, MD;, K. C. Min, MD, PhD;, C. Commichau, MD; and G. L. Bernardini, MD, PhD

From the Division of Critical Care Neurology, Department of Neurology, Columbia–Presbyterian Medical Center and College of Physicians and Surgeons of Columbia University, New York, NY.

Address correspondence and reprint requests to Dr. S.A. Mayer, Division of Critical Care Neurology, Neurological Institute, 710 W. 168 St., Unit 39, New York, NY 10032; e-mail: sam14{at}columbia.edu

Five cases of presumed nicotine withdrawal delirium among brain-injured patients treated in a neurologic intensive care unit are presented. Each patient had a history of heavy tobacco use and experienced dramatic and sustained clinical improvement within hours of transdermal nicotine replacement. These preliminary observations suggest that nicotine withdrawal may be an under-recognized cause of delirium in patients with acute brain injury.




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