Excited delirium (EXD), first described in the mid 1800’s, has been referred to by many other names – Bell’s mania, lethal catatonia, acute exhaustive mania and agitated delirium. Regardless of the label used, all accounts describe almost the exact same sequence of events: delirium with agitation (fear, panic, shouting, violence and hyperactivity), sudden cessation of struggle, respiratory arrest and death.