Dissociative Fugue Differential Diagnosis for a 92-year-old
Single Most Likely Diagnosis
- Dementia with wandering: Given the age of the patient, dementia is a common condition that can cause disorientation, confusion, and wandering, which may be mistaken for dissociative fugue.
Other Likely Diagnoses
- Delirium: An acute and reversible condition that can cause confusion, disorientation, and altered level of consciousness, which may be triggered by medical conditions, medications, or environmental factors.
- Depression with psychotic features: Older adults with depression may exhibit psychotic symptoms, including disorientation and confusion, which can be mistaken for dissociative fugue.
- Vascular dementia with fugue-like episodes: Some patients with vascular dementia may experience fugue-like episodes, characterized by sudden and unexpected travel away from home or work, often with no memory of the past.
Do Not Miss Diagnoses
- Hypoglycemia: A potentially life-threatening condition that can cause confusion, disorientation, and altered level of consciousness, which may be mistaken for dissociative fugue.
- Infection (e.g., UTI, pneumonia): Older adults may exhibit confusion, disorientation, and altered level of consciousness as a result of infection, which requires prompt medical attention.
- Medication side effects or interactions: Certain medications or combinations of medications can cause confusion, disorientation, and altered level of consciousness, which may be mistaken for dissociative fugue.
Rare Diagnoses
- Transient global amnesia: A rare condition characterized by sudden and temporary memory loss, often triggered by physical or emotional stress.
- Epileptic fugue: A rare condition in which a person experiences a fugue-like state as a result of a seizure disorder.
- Factitious disorder: A rare condition in which a person intentionally fabricates or exaggerates symptoms, including dissociative fugue, for attention or other gains.