Disturbances of consciousness are manifestations of dysfunction of certain areas of the brain, which may be accompanied by a temporary complete or partial loss of connection with reality, hallucinations, delusions, aggression or a feeling of fear.
Disturbances of consciousness include stupor, stupor, coma, twilight stupefaction and some other conditions in which the patient is not capable of adequate perception of reality.
Why does consciousness disappear?
The main causes of disturbances of consciousness include:
- without visible structural changes in the brain;
- and electrical activity of the brain;
- , metabolic and mental diseases;
- drug addiction, alcoholism, substance abuse;
Types of disorders and disorders of consciousness
Disorders of consciousness are divided into two large groups: quantitative and qualitative. The quantitative group includes coma, stupor (somnolence) and stupor. Qualitative ones include twilight stupefaction, ambulatory automatism, fugue and some other disorders of brain activity.
Main types of disturbance and/or clouding of consciousness:
- Stupor (). Translated from Latin, this word means “numbness.” A patient in a stupor stops reacting to the surrounding reality. They don’t even cause a reaction from him loud noise and inconveniences such as wet beds. During natural disasters (fires, earthquakes, floods), the patient does not realize that he is in danger and does not move. Stupor is accompanied by movement disorders and lack of response to pain.
- Twilight stupefaction. This type of disorder is characterized by sudden and also suddenly disappearing disorientation in space. A person retains the ability to reproduce automated habitual actions.
- Locked-in syndrome. This is the name of a condition in which the patient completely loses the ability to speak, move, express emotions, etc. Those around him mistakenly believe that the patient is in a state of flux and cannot adequately respond to what is happening. In reality, the person is conscious. He is aware of everything that is happening around him, but due to paralysis of his entire body, he is unable to even express emotions. Only the eyes remain mobile, through the movement of which the patient communicates with others.
- . This is a condition in which the patient is conscious but confused. Him
understanding of the surrounding reality is maintained. The patient easily finds the source of sounds and reacts to pain. At the same time, he completely or practically loses the ability to speak and move. After their healing, patients say that they were fully aware of everything that was happening around them, but some force prevented them from adequately responding to reality. - . Characterized by constant desire fall asleep. At night, sleep lasts much longer than it should. Awakening usually does not occur without artificial stimulation, such as an alarm clock. It is necessary to distinguish between 2 types of hypersomnia: the one that occurs in completely healthy person, and one that is typical for people with mental and other types of disabilities. In the first case, increased drowsiness may be a consequence of chronic fatigue syndrome or. In the second case, hypersomnia indicates the presence of a disease.
- Stun(or stunned consciousness syndrome). During deafening, the already mentioned hypersomnia and a significant increase in the threshold of perception of all external stimuli are observed. The patient may experience partial amnesia. The patient is unable to answer the most simple questions, hearing voices and knowing where the source of the sound is. There are 2 types of stunning consciousness. In more mild form the patient can carry out the commands given to him, moderate drowsiness and partial disorientation in space are observed. In a more severe form, the patient performs only the simplest commands, his level of drowsiness will be much higher, and disorientation in space will be complete.
- Wakeful coma (). Develops after serious ones. This condition received the name “coma” because, despite being conscious, the patient is not able to come into contact with the outside world. The patient's eyes are open eyeballs rotate. At the same time, the gaze is not fixed. The patient has no emotional reactions and speech. The patient does not perceive commands, but is able to experience pain, reacting to it with inarticulate sounds and chaotic movements.
- . A mental disorder that occurs with disturbances of consciousness. The patient suffers from visual hallucinations. Him
disorientation in time is observed, orientation in space is partially impaired. There can be many causes of delirium. Elderly people and alcoholics suffer from hallucinations. Delirium may also indicate the presence of schizophrenia. - . Due to injury and for some other reasons, a person loses the ability to be mentally active. The patient's motor reflexes are preserved. The cycle of sleep and wakefulness is maintained.
- Dissociative fugue. A type of mental disorder in which the patient completely loses his previous personality and begins to new life. The patient usually seeks to move to a new place of residence, where no one knows him. Some patients change their habits and tastes and take a different name. A fugue can last from several hours (the patient, as a rule, does not have time to radically change his life) to several years. Over time, there is a return to the previous personality. The patient may lose all memories of the life he led during the fugue period. Mental disorder can be caused by events of a traumatic nature: death loved one, divorce, rape, etc. Psychiatrists believe that fugue is a special defense mechanism our body, allowing us to symbolically “escape” from ourselves.
- . A confusional disorder in which the patient loses the ability to synthesize. For him, the overall picture of the world falls apart into separate fragments. The inability to connect these elements with each other leads the patient to complete disorientation. The patient is not capable of productive contact with the surrounding reality due to incoherent speech, meaningless movements and the gradual loss of his own personality.
- Coma. The patient is in an unconscious state, from which it is impossible to revive him using conventional methods. There are 3 degrees of this condition. In a first-degree coma, the patient is able to respond to stimuli and pain. He does not regain consciousness, but responds to irritation with defensive movements. While in a second-degree coma, a person is unable to respond to stimuli or experience pain. In third degree coma, vital functions are in a catastrophic state, muscle weakness is observed
atony. - Short-term loss of consciousness (,). Fainting is caused by a temporary disruption of cerebral blood flow. The causes of short-term loss of consciousness can be conditions of low oxygen content in the blood, as well as conditions accompanied by disturbances in the nervous regulation of blood vessels. Syncope is also possible with some neurological diseases.
Twilight state of consciousness and its types
Stupefaction (twilight) occurs with, and. This type of disorder of consciousness is called transient, that is, it occurs unexpectedly and passes quickly.
Long-term stupefactions (up to several days) are possible mainly in epileptics. This condition may be accompanied by fear, aggression and some other negative emotions.
Twilight disorder of consciousness is characterized by hallucinations and delusions. The visions are frightening. Expressed aggression is directed towards people, animals and inanimate objects. A person suffering from twilight darkness is characterized by amnesia. The patient does not remember what he said and did during his seizures, and does not remember the hallucinations he saw.
Twilight consciousness occurs in several variants:
- Outpatient automatism. This condition is not accompanied by delusions, hallucinations or aggressive behavior. Outwardly, the patient’s behavior is no different from his behavior in his normal state. A person automatically performs all usual actions. The patient may wander aimlessly along the street, following familiar routes.
- Rave. The patient's behavior does not always change. This state is characterized by silence and an absent gaze. The patient may show aggression.
- Oriented twilight stupefaction. The patient retains consciousness in fragments and is able to recognize close people. Delusions and hallucinations may be absent. The patient experiences fear or aggression.
- Hallucinations. The visions that visit the patient during an attack are threatening. Patients see red or blood. Visions may include fictional characters or fantastic creatures that show aggression. The patient begins to defend himself, causing harm even to those closest to him.
At the first signs of twilight conditions, a person must be provided with pre-medical assistance, care and observation. The patient should not be left alone. If consciousness is not completely lost, contact can be maintained with it.
Sometimes familiar faces become the only reference point for someone who has lost touch with reality. You should not wait until the patient completely loses contact with the outside world. He needs urgent transport to the hospital.
First aid for impaired consciousness
During a patient's attack, people around him must take urgent measures. If consciousness is completely lost, you need to try to bring the person to his senses: give him a sniff of ammonia, put it on his head soaked in cold water napkin. 
You should also immediately call " ambulance", even if the person who lost consciousness managed to recover from the fainting state.
In case of partial loss of consciousness, assistance first aid may be complicated by inappropriate behavior of the patient. If there is an incomplete loss of contact with reality, it is necessary to conduct a constant dialogue with the person so that a complete break with reality does not occur.
The patient should not be left alone with himself. However, others need to remember that in such a state a person may be susceptible to various kinds of hallucinations. He is capable of harming those he loves.
Providing medical care
A person suffering from any type of mental disorder must be constantly monitored by a psychiatrist and undergo timely medical examination. Since the causes of impaired consciousness may vary, treatment may also differ in each individual case.
For example, if a patient suffers renal failure, he is prescribed hemodialysis. In case of overdose drugs 
Naloxone is required. Loss of consciousness caused by alcohol poisoning requires large doses of thiamine. In addition, in case of any poisoning, you must first rinse your stomach.
If during the next attack the patient lost consciousness for a long time, fell into a coma, vegetative state or stupor, the doctor needs to assess vital functions and find out whether the patient’s body can independently support its vital functions.
(Tizercin, ) - drugs most often used in the treatment of disorders of consciousness, administered intramuscularly. To prevent the collaptoid state, Cordiamine is prescribed. If the first signs are present, the patient must be hospitalized. A nurse is assigned to the patient for care and constant monitoring.
Disturbances of consciousness are a group mental illness and disorders that prevent the patient from providing self-help. The relatives and friends of a sick person have a huge responsibility.
They should not allow the patient long time remained left to his own devices, and at the first sign of a seizure, they were obliged to be able to help him.
Disorientation is a condition in which a person loses the ability to think and act clearly and clearly. Depending on the type of disorientation, the patient loses the ability to recognize the place where he is and remember what happened to him. As a result, confusion arises, and the person can no longer make any decision on his own.
How does disorientation and confusion manifest?
A person in a state of disorientation is not able to realize his own personality, place of residence, time, social affiliation. Sometimes only one specific type of disorientation is noted, but in some cases a person exhibits a combination of the types of disorientation described above.
Early signs of confusion include orientation disorder , decreased attention . If this condition progresses, then the patient’s perception of the surrounding world and memory are gradually impaired, and later speech disorders occur. The patient does not recognize those who are next to him. Sometimes he has illusions – incorrect perception of what is happening around. As a rule, confusion leads to the fact that a person becomes silent, depressed, and moves very little.
Confusion in older people is characterized by a noticeable loss of orientation, confusion, and inability to act independently. Symptoms of confusion may appear gradually or suddenly. This syndrome can be either temporary (for example, patients periodically develop night disorientation ), and constant. Causes of confusion in older people can also be related to stress. It is important to contact a specialist in a timely manner, since correct treatment confusion can slow down the development of the disease and delay the onset of progression.
Severe dizziness And confusion after anesthesia – a physiological phenomenon that disappears over time.
If confusion appears suddenly in a person and at the same time he has psychomotor hyperactivity and , then the patient is diagnosed delirium . Progressive and long-lasting confusion with gradual loss of a number of innate functions is defined as dementia.
General disorientation is also accompanied by autopsychic disorientation, which is characterized by a variety of emotional disorders, disturbances in orientation in one’s personality.
gradually leads to a noticeable change in a person’s personality. A person who has emotional and moral disorientation cannot distinguish between bad and good deeds, good and evil inflicted on other people. Symptoms of disorientation can be expressed by apathy, indifference to what is happening around.
Personal disorientation is manifested by a violation of orientation in a person’s consciousness and self-awareness. Disorientation in time periodically occurs - the patient does not understand what period of the day or day of the week it is, and is confused about what happened just now and earlier.
The causes of disorientation in space, time, self, confusion are serious symptoms indicating the development of diseases. Therefore, consultation with a doctor in this case necessary.
Why does disorientation and confusion occur?
Social disorientation occurs due to various reasons related to diseases and pathological conditions. In children, this syndrome may be associated with sudden changes in life, for example, the beginning of visiting kindergarten, schools.
In young children, the manifestation of social disorientation is a physiological phenomenon. Small child is not able to correctly identify his own gender or occupation; he has difficulty finding his way around a group of new people. Only in adolescence does a period of full social orientation begin. But if parents suspect that the child is experiencing disorientation not related to age characteristics, you should definitely contact a specialist, as this sign may indicate the development dementia And mental retardation .
Disorientation in humans is often associated with organic brain damage, as well as metabolic disorders. In older people, confusion and disorientation are often associated with.
Confusion may result hypoxemia , which manifests itself in diseases of the lungs, as well as nervous, cardiovascular systems. This symptom can occur with severe infections, severe malnutrition, and dehydration.
Thus, confusion may be a symptom of the following diseases: brain tumor , circulatory disorders in the brain , head injuries , hypoxemia , endocrine disorders , metabolic disorders .
Confusion of consciousness also manifests itself under the influence of certain external factors. Impaired consciousness is possible with severe hypothermia, with heatstroke. Often this symptom is observed in people who have been intoxicated for a long time, taken drugs or potent psychotropic medications.
How to get rid of disorientation and confusion?
To provide effective treatment diseases in which a person exhibits disturbances of consciousness and orientation, it is necessary to conduct a comprehensive examination and establish an accurate diagnosis. Initially, the specialist conducts a detailed survey of the patient and his loved ones. If there is a suspicion of organic brain damage, it is necessary to carry out biochemical research blood, others lab tests, EEG, MRI or CT, study of metabolic disorders.
If the diagnosis is established, it is carried out complex treatment underlying disease. It is important to discontinue all medications and ensure that there are no factors that may trigger confusion.
If we are talking about senile dementia
, then care should be taken not only to treat the patient, but also to ensure proper care behind him. With senile dementia, a person experiences a number of symptoms: loss of orientation when walking, incoherent thinking, loss of awareness of one’s own personality. It should be taken into account that people with dementia may experience both short-term loss of orientation and loss of spatial orientation for a longer period. If the patient experiences disorientation and dizziness regularly, he should not be left alone on the street.
It is important to remember that loss of orientation in space can lead to the patient simply getting lost. It is also necessary to ensure maximum patient safety. If necessary, mechanical aids can be used. A person who is marked senile dementia – a disease of loss of orientation in time and space – should be in the most calm and friendly environment. If the patient has only temporary loss of orientation, it is advisable to always keep a calendar and watch next to him. If possible, the patient should be constantly looked after by a nurse or one of the relatives. Depending on the patient’s condition, the doctor allows him to sit, walk, or go outside.
Sometimes patients with confusion are prescribed antidepressants. It is important to constantly monitor your pulse and prevent dehydration.
If a person becomes confused suddenly, they should immediately consult a doctor. For example, disturbances of consciousness can suddenly appear in diabetes mellitus if the blood sugar level drops sharply.
If a child has severe social disorientation, it is necessary to consult a psychologist. The specialist will tell you which behavior model to prefer in order to promote social adaptation child.
As a preventive measure against impaired consciousness and orientation, it is advisable to adhere to the principles proper nutrition, do not abuse alcohol, regularly get enough sleep. Sick diabetes mellitus You need to constantly monitor your blood sugar levels. Elderly people should take the medications prescribed by the doctor. To prevent senile dementia, it is important to lead an active life whenever possible and be sure to train your memory and brain.
Confusion is characterized by a person's clouded consciousness, which includes speech disturbances, drowsiness and hallucinations. The pathology can be temporary or permanent, depending on the reason for which it appeared. This condition can develop against the background of psychological disorders, neurological diseases, or circulatory problems in the brain. This condition requires specialist supervision, careful diagnosis and treatment.
Pathogenesis and classification
Confusion is not an independent disease, but only a symptom that combines certain elements of amentia and delirium. In this case, the patient is disoriented in space, time and place. Patients complain of lack of concentration when receiving any information and confusion.
The syndrome can manifest itself gradually or rapidly, depending on the reasons against which it began to develop. Most often it is temporary and disappears completely after treatment of the disease. But in some cases it can be permanent. In this case, it is associated with dementia or delirium.
Confusion in older people is always chronic. It is for this reason that they can adapt to this condition to some extent. But if the symptom persists for a long time, a negative outcome is possible. In this case, hallucinations and mood changes are observed. People suffering from impaired consciousness in old age must be treated with caution.
With vegetative-vascular dystonia, confusion of consciousness is also noted. The pathology is characterized by a violation of blood circulation in the brain, in which it suffers vegetative system. As a result, they may appear fainting states and speech disorders.
More often this symptom noted when cervical osteochondrosis. The disease is characterized by disruption of the structure of the intervertebral disc, which leads to pinching of nerve endings and blood vessels.
It is quite difficult to obtain an anamnesis in patients suffering from confusion. In this case, the doctor can consider many various diseases. In addition, the clinical picture may change, which prevents diagnosis.
Depending on the age of the patient and the etiological factor, several forms of this condition are distinguished. These include:
Confusion in older people is separate form, since the disorder can develop against the background of certain diseases and age-related changes.
The treatment regimen is determined after establishing the type and cause of the symptom, since in some cases treatment of concomitant diseases is required.
Causes
Experts have identified a number of factors that can provoke the appearance of impaired consciousness. Most often this is a decrease in immunity and intoxication after consumption large quantity alcoholic drinks. In addition, this condition can occur with the following pathologies:
TO possible reasons also include:
In addition, this condition may occur as a result of oxygen starvation when the brain stops receiving enough oxygen.
Clinical picture and diagnosis
With confusion, symptoms may vary depending on the age of the patient and the cause.
Most often it is characterized by the inability to reason adequately, a feeling of disorientation in space, time and place. There is also a violation of attention when the patient is unable to concentrate while talking, reading or listening to any information.
Impaired consciousness can develop gradually or rapidly, depending on the reasons for its occurrence. Most often this disorder is temporary, but sometimes it is considered permanent, incurable and associated with dementia.
Symptoms include:
- Speech impairment. It is difficult for others to understand a person suffering from confusion, as he confuses sounds and endings, and there are long pauses in conversation.
- Disorientation. The patient is lost in an unfamiliar environment.
- The patient loses the essence of the task that was entrusted to him.
- Sudden changes in mood. Attacks of aggression or unreasonable joy may occur.
- Inattention.
In some cases, symptoms may be supplemented by hallucinations, delusions and constant drowsiness.
If signs of confusion appear, you should contact your local physician.
First of all, the doctor conducts an examination and takes a medical history. If necessary, a consultation with a psychiatrist can be scheduled. If mental disorders are detected, treatment is carried out jointly. In order for the specialist to more accurately establish the diagnosis and the cause of its occurrence, it is recommended to come to the appointment with a close relative who can describe the current condition and answer all the doctor’s questions. After establishing a preliminary diagnosis, the following diagnostic research methods are prescribed for confirmation:
Based on the data obtained, the doctor determines the cause of the disease and prescribes treatment.
Treatment
For confusion, treatment is most often carried out in a hospital setting. Specialist supervision is necessary when post-traumatic psychosis or serious impairment is detected. If possible, doctors advise relatives to stay close to the patient. The following drugs are prescribed for treatment:
Medicines are administered intramuscularly or intravenously, starting in small doses. Taking them on your own and determining the required dose is strictly prohibited, as this can be fatal.
The patient also needs to be provided with complete rest and care, since he is not responsible for his actions. The duration of treatment depends on the age of the patient and the cause of the disturbance of consciousness.
Osteochondrosis and confusion
Impaired consciousness may be one of the symptoms of osteochondrosis. The disease is characterized by limited joint mobility cervical region spine, which causes insufficient blood supply to the brain.
During prolonged work at the computer, the head is in an unnatural position. If this happens regularly, then irreversible changes begin in the structure of the intervertebral disc, which provokes the development of the disease.
Another common cause of osteochondrosis is stress. Being in this state constantly, a person begins to slouch, lowers his head down and does not relax.
Thus, a violation of the structure of the intervertebral discs and a depressive state can lead to confusion. In this case, it is necessary first of all to get rid of osteochondrosis and depression.
In order to avoid the occurrence of impaired consciousness, it is necessary to limit the consumption of alcoholic beverages, foods high in cholesterol and get rid of bad habits. Patients are also advised to adhere to proper nutrition, do morning exercises and constantly train their thinking and develop their memory.
Confusion is not an independent disease and manifests itself against the background of various disorders of the brain, intoxication or drug intake. medicines. May be permanent or temporary. In older people, it often develops against the background of dementia. Treatment is carried out with the help of sedatives, but more often treatment of the root cause of the symptom is required.
Confusion (delirium) common mental disorder, arising from a variety of forms of bodily distress: infectious diseases, intoxication, burns, injuries, drug overdoses, high temperature, hypothermia, hypertensive crises, dysfunction of the liver and kidneys, metabolic disorders, etc.
Confusion can occur at any age, but much more often in children and the elderly, and much less severe causes are sufficient for its occurrence. Thus, in an elderly person, delirium can occur due to an overdose of the drug he usually takes, mild pneumonia or a cold, or increased blood pressure, temporary disorder cerebral circulation, food poisoning, dehydration, after mild surgery and so on. For delirium to occur in an elderly person, even so-called sensory deprivation is enough, that is, a significant reduction in the number of external stimuli acting on the senses, when a person lives alone, in poor lighting, in silence and does not communicate with anyone.
In older people, delirium also often occurs against the background of pre-existing age-related dementia - Alzheimer's, vascular or other; In patients with vascular dementia, delirium often occurs after episodes of cerebrovascular accident. The duration of delirium can vary - from half an hour to several weeks and even months, while the degree of its severity usually fluctuates even within a day - periodically the disorders disappear, consciousness clears up, correct orientation in the environment appears, but then the symptoms return, for the most part in the evening and at night. Deterioration of the condition in the evening and at night is especially typical for elderly patients who are in hospitals for a variety of reasons - an attack of angina or myocardial infarction, hypertensive crisis, surgery, etc.
Confusion may develop in them in the evening even with a satisfactory somatic condition. During the daytime, such people are quite orderly, correctly oriented in their surroundings, but towards evening, with the onset of darkness, they become confused, fussy, anxious, begin to experience illusions and hallucinations, try to go or drive somewhere, stop recognizing others, which greatly frightens those who come. on a date with relatives.
Regardless of what conditions caused it, delirium is a condition that requires urgent treatment medical care, and often hospitalization. It is impossible to INTERVIEW such a patient without observation, since under the influence of allucinatory experiences he can commit actions that are good for himself and those around him.
Treatment of delirium involves searching for the cause that caused it, IOOCHHO where it is unclear, therefore laboratory and clinical examination is necessary. To relieve agitation, benzodiazepines are used, for example, diazepam 2-4 ml of 1,!I|.-solution intramuscularly or intravenously every 4-6 days, phenazepam orally, etc. However, in elderly patients ||long-term use of benzodiazepines is undesirable; it is better to use antipsychotics: sonapax, chlorprothixene, \#and<ю галоперидол в малых дозах (1,5-3 мг), либо карбамазепин. Сим-\ Яшмы тревоги у них могут быть значительно уменьшены приемом |-Г)/1окаторов - атенолола, анаприлина, индералаидр. Необходимы tih*e витамины, сердечные препараты, обильное питье. Иногда при Пораженном возбуждении на короткое время могут потребоваться »|и"цс I ва физического стеснения - фиксация пациента к кровати за И|н"Д1 шечья и голень с помощью полотенца.
Delirium will end much faster if the patient is not suitable for it in isolation - someone must always be next to him! relatives or staff, you need to talk to him, \\ give him a drink, hold him by the hand, explain where he is, what time it is, who is surrounding him, etc.; the room should have a dim light turned on, it is highly desirable to have a radio, television and other means of preventing basic deprivation. You must remember: the absence of irritation at night (darkness, silence, loneliness, lack of opportunity to talk with anyone) can significantly increase anxiety and motor agitation.
Pathology is manifested by a violation of perception:
- maintain control over what is happening around him.
- A person constantly listens to himself, waiting for the progression of the disease.
- The brain tries to get rid of the negative impact, derealization progresses.
- Fear for health intensifies with even greater aggravation of symptoms.
- A common symptom is weakness in the legs: they become “wobbly.” A person runs the risk of losing balance and falling.
- Increased or decreased acoustic perception, when sounds seem too loud or muffled, as if coming from “under the pillow.”
Relationship between symptoms and VSD
Below are the stages of possible development of this symptom:
The vicious circle closes. The patient needs help to combat VSD and derealization.
Depersonalization and VSD
Derealization is often accompanied by another change in psychological state - depersonalization.
Variants of confusion
Human consciousness is a matter that remains a mystery. No doctor can say for sure why one patient with VSD develops derealization and another does not.
Most scientists agree on the innate abilities of the nervous system to resist stress and other negative influences.
- Stun. The patient demonstrates decreased motor activity. Drowsiness progresses. Patients describe the sensation as confusing, as if “in a fog.” Derealization progresses.
- stay home alone;
- antidepressants;
- neuroprotectors.
- antiarrhythmics;
- analgesics.
- Psychotherapy. The best way to understand the root causes of the problem, normalize your well-being and set you up for positive thinking.
- Massage and physiotherapy. Relaxing procedures strengthen a person’s psyche and increase their resistance to stress.
- weakening of will and motivation;
- inactivity and lack of initiative;
- the appearance of sloppiness;
- if there is a suspicion that the person is in the grip of delusion and hallucinations are taking place.
- With panic attacks typical of VSD, short-term memory impairment is observed.
- communicate adequately with the doctor or other people;
- describe life in chronological order;
- The first panic attack causes the patient to experience unpleasant moments.
- Staying in constant anticipation of stress increases the risk of a second attack, which develops with even greater force.
- First, headaches and dizziness progress, the pulse quickens, and sweating increases.
- The breathing rhythm is disrupted. Chest discomfort progresses.
- Feelings of “already seen” (déjà vu) or “never seen” (jamais vu).
- The sense of light and color becomes more intense or dull: previously bright colors look dull or vice versa.
- A person's time orientation changes. It seems to the patient that the day flies by in a minute. Episodes of panic attacks are perceived as too prolonged an experience, although they do not last long.
- It is enough for the patient to experience emotional stress once, and he expects the condition to worsen.
- A person thinks about who he is and why he lives.
- In severe cases, patients felt unreality and incompatibility of consciousness with the body. Against this background, suicidal depression progresses.
- Drowsiness.
- Brief loss of consciousness without visible symptoms. A person “disconnects” from reality for seconds, but maintains balance. People around you may not even notice it. In some cases, we are talking about a special type of stupefaction (epileptic “twilight”), for example, with absence seizures and ambulatory automatisms.
Obsessive thoughts during VSD
With autonomic dysfunction, obsessive ideas and thoughts that are associated with fear for health progress, they are called phobias. A person is afraid:
The patient undergoes frequent examinations by the doctor. The doctor’s assurance that there is no somatic disorder is perceived with distrust, and sometimes with aggression.
Features of treatment
The medical approach to the progression of the feeling of derealization includes the use of the following groups of drugs:
Derealization is an uncommon sign of autonomic dysfunction. Treatment of pathology quickly stabilizes the psychological and somatic health of the patient.
The help of a psychiatrist is required if the symptoms of derealization are accompanied by:
Confusion: Symptoms, Causes and Treatment
Confused is generally understood as a state of consciousness in which the ability to think at normal speed is lost and the clarity and consistency of thoughts are disrupted. This name summarizes a whole group of injuries in the complex functioning of the brain. Let's take a closer look at the concept of “confused consciousness.”
Symptoms of the disease
The first signs to detect confusion are problems with attention and orientation. Then memory and logical thinking disorders may begin to appear. The disorder does not necessarily affect all higher mental functions at once; only one of them, for example, speech recognition, may be damaged. There may be problems with memory or spatial orientation. In such cases, the diseases are respectively called aphasia, dementia and agnosia.
Fast and slow manifestation of the syndrome
The onset of confusion syndrome can be either fast or slow, depending on the causes that cause it. Often it is temporary, but it can also be permanent, usually associated with dementia and delirium.
Individuals with confusion are usually very silent, move little and appear depressed. It happens that the disease is accompanied by illusions and hallucinations. If the former arise due to incorrect interpretation of stimuli, then the latter appear without them at all.
It must be understood that confusion manifests itself individually in everyone, depending on the degree of intoxication or the severity of another cause. Slowness and inconsistency of thinking are clearly visible in conversation, and these are the first symptoms accompanying the diagnosis of “confusion.” Therefore, in order to see the presence of a problem, you do not need to be a professional.
Disorientation, its varieties
Disorientation can be either allopsychic, in which a person is unable to name the date and place in which he is now, or autopsychic, in which his own identification becomes difficult. It is also easy to determine the presence of disorientation by asking a couple of questions. Based on the answers, the result is obvious - the consciousness is clear; if it’s confused, it means it’s time to get professional help. You should consult a psychiatrist or narcologist.
When providing assistance, it is necessary to pay sufficient attention to the meaning of the word “confused.” A person in such a situation really experiences difficulties in making decisions, including those regarding consent to hospitalization, so often in such cases there is a need to carry it out based on the indications of the condition.
Dependence on the root cause
Root causes often cause characteristic symptoms to appear. With VSD, obvious vegetation and moderate pain are visible; with a heart attack, the pain syndrome is very pronounced and can sometimes cause a state of shock. Metabolic causes are usually accompanied by various characteristic manifestations, such as odors.
In older people
Confusion in older people is chronic, so they can partially develop an adaptation to it. If this condition lasts for a long time, it will most likely lead to a negative outcome. Speech in such cases is usually slow, there may be inconsistencies in it, sometimes delusional ideas can be seen, and illusory images may arise that turn into hallucinogenic ones. The mood of such people also often changes and is difficult to predict, so you should treat them with caution. Changes in sleep are also observed, and they can be diametrically opposed: from complete insomnia to excessive drowsiness.
Diagnostics
To make a diagnosis, both a classic survey and special neurological and psychiatric ones, for example the Glasgow Coma Scale, are used. And in case of organic diseases, it is necessary to conduct a blood test, urine test, ECG and MRI. This will help identify the root cause and begin proper treatment.
Confused consciousness: causes of occurrence
This violation can manifest itself due to a number of completely different reasons. That is why it cannot be a signal of a certain pathology, but it is necessary to be aware of its danger and try to find the cause. One thing is clear: such a disease indicates that the patient has a neurological problem.
Let's consider the possible causes of confusion:
1. Traumatic. The disease can be a consequence of traumatic brain injuries, especially if they are penetrating in nature. Although sometimes a brain injury can cause similar problems due to the high sensitivity of brain tissue. Often the cause is aneurysms, characterized by a large number of dangerous manifestations.
2. Toxic. The cause of the disease can be poisoning with mercury, alcoholic beverages or drugs. In wartime, various neurotropic gases and organophosphorus substances were used as weapons that act in a similar way. Neurotoxins can be found in foods such as carambola and puffer fish. The occurrence of similar consequences of mushroom poisoning is also common.
3. Consequences of diseases. Diseases accompanied by severe intoxication of the body and hyperthermia (flu, sore throat, acute respiratory infections and others) sometimes lead to confusion. This is especially true for children and adolescents. The risk of such conditions arises from injuries, fractures and large blood losses. Tuberculosis and syphilis are other possible causes. The cause may also be encephalitis, acute diabetes mellitus, severe hepatitis of various types, and the final stages of AIDS.
4. Neoplastic manifestations, and not necessarily occurring in brain tissue. This is due to the fact that tumors are always accompanied by severe intoxication, so confusion in late-stage cancer becomes inevitable. The danger is posed not only by classical tumors, but also by leukemia. It appears in 15-30% of patients, and by the last weeks of life reaches 85%. It adds additional stress to the patient and his family and affects the symptoms and methods of cancer treatment, including adjusting the effect on pain.
5. Blood circulation pathologies. Both serious disorders, such as stroke, and ischemia, which are considered transient, i.e. occurring without consequences and only being a signal of the presence of problems, often provoke confusion. The severity of the disease and the manifestation of symptoms will vary depending on the severity of the pathology that serves as the trigger. With myocardial infarction, confusion occurs due to problems with blood circulation and the severity of pain sensitivity.
6. Vegetovascular dystonia due to partial disturbances in the areas of blood vessels and the autonomic nervous system, it is also accompanied by mild confusion.
7. Summary of degenerative diseases. The manifestation can occur to a severe degree at the peak of senile dementia, marasmus of various origins, and Alzheimer's disease. In this case, it is caused by problems with brain activity and problems with orientation.
The starting points for such processes can be a wide variety of situations of varying severity. For emotionally weak people, a strong emotional shock is enough. Even a lack of vitamins, hypothermia, and prolonged lack of sleep and oxygen can lead to similar consequences.
Treatment of confusion
To treat confusion, it is initially necessary to establish the cause of its occurrence and then eliminate it. Since some medications are often the cause, it is necessary to stop taking all medications until all metabolic disorders are corrected. The etiology of confusion is often easy to determine due to specific symptoms, but sometimes a full physical examination can help with this.
Alcohol as a reason
Sometimes you can determine the cause and correct the triggering factors yourself. This applies to alcohol intoxication and lowering blood sugar levels. When your sugar level drops, sweet tea or candy will help. If you lose a large amount of fluid, you should resort to rehydration therapy using products available at the pharmacy. Absorbents and plenty of liquid will help against alcohol intoxication.
If the cause is an injury, it is important to identify and eliminate it in time. Sometimes this requires the use of neurosurgery. After an ischemic stroke, thrombolytics are used; for hemorrhagic stroke, surgical removal of the hematoma is practiced. Exposure to toxic substances, in particular heavy metals, and radiation exposure also require appropriate targeted treatment. Diseases accompanied by intoxication of the body and elevated temperature are treated with the use of antiviral and antipyretic drugs. For VSD, the daily routine and diet are adjusted, and sedatives and teas are also used: chamomile, mint, lemon balm.
There are certain medications that can help get rid of the disease, but the most effective is maintaining a therapeutic and protective regimen. If the patient is in an excited state, beds with fences on the sides or a special chair are used. Sometimes doctors are forced to resort to fixing the patient, but it is advisable to avoid this, giving him the opportunity for unrestricted movement in a limited space.
Disorientation in time
If the illness is associated with time disorientation, it is important to ensure that there are things in the room that help you navigate: large calendars and clocks. This will reduce anxiety and help patients feel more confident. If you have insomnia, you should provide the patient with a radio or leave him a book and a lamp on, which will help occupy time. In general, it is important to communicate with the patient and support his faith in recovery. Confusion in cancer is alleviated in this way.
If such drugs do not have a sufficient effect, they resort to drug treatment, usually consisting of taking antipsychotics. At the same time, there is no exact information about the advantage of any drugs over others; the main parameter is the presence of a sedative effect. However, they cannot always be used. The medicine is first prescribed in a minimal dose, and then it is gradually increased, while observing the reaction that occurs. It is important that there is no manifestation of the opposite effect - an increase in behavioral disorders.
It is also difficult to restore the sleep-wake cycle. Sometimes, to improve night sleep, the patient is not allowed to fall asleep during the day. Sleeping pills rarely have the necessary effect and more often the cycle returns to normal only after the confusion has passed.
Features of derealization in VSD
Derealization is a strange state in which the surrounding world is perceived as alien, artificial, distant. This condition is not a psychotic disorder. Derealization may well be present with vegetative-vascular dystonia, and especially with panic attacks.
Derealization is a complex symptom complex that develops against the background of functional or organic damage to the central nervous system with the appearance of a feeling of “separation” from the outside world.
After normalization of the emotional background, the person remembers everything, and the period of amnesia is resolved.
Derealization is one of the disorders of “minor psychiatry”. A person suffering from VSD in combination with a pathology of perception is oriented in time and space.
A patient with a similar diagnosis is sane. He is aware of the problem, seeks help, and wants to get rid of the disease.
This feature of derealization differs from schizophrenia and other mental conditions that are characterized by denial of deviation.
The relationship between derealization and dystonia is not obvious, but it is strong. The symptom occurs during a panic attack. Defense mechanisms are triggered in the brain with the release of biologically active substances.
A similar reaction in the central nervous system is observed when using certain types of drugs (LSD, mescaline). Against the background of such a change in metabolism, a distortion of perception progresses with the appearance of the sensations described above.
The feeling of unreality in patients with VSD is an attempt by the brain to protect itself from negative external influences.
The relationship between vegetative-vascular dystonia and derealization is further manifested in the need for the central nervous system to counteract psychological pressure.
Symptoms
The condition is accompanied by a number of additional symptoms, which are clear signs of a panic attack:
Common additional symptoms of derealization:
The symptoms of derealization are specific, and such manifestations of VSD are not common in the population. A person with dystonia is characterized by more emotional lability than periods of derealization.
Perceptual distortions are highlighted in the International Classification of Diseases, Tenth Revision (ICD 10), as they develop in parallel. They indicate a complex dysfunction of the central nervous system:
Derealization and depersonalization against the background of VSD, as well as other chronic conditions, are reversible symptoms. It is enough to get rid of the main problem, and the perception of the surrounding world and one’s own “I” in this world will be normalized.
The factor that provokes dystonia and psychological changes is constant stress. It feeds the negative thoughts of a person with deteriorating well-being.
In addition to derealization, there are degrees of confusion that are characteristic of patients with VSD:
Against the background of autonomic dysfunction of cerebral vessels and stress, a person may well faint. To prevent the consequences of derealization, therapy must be started on time.
The degree of severity of obsessive thoughts during VSD in combination with derealization depends on the person. In practice, such a combination in patients with dystonia is rare.
The main feature of changes in psychological state remains dysfunction of the autonomic nervous system. Therefore, therapy for VSD and derealization coincides. If it is possible to normalize the functioning of the ANS, stabilize the patient’s well-being with the leveling of typical symptoms, then the psychological state will quickly return to normal.
Improving the functioning of the central nervous system and autonomic nervous system will reduce the severity of anxiety and put thoughts in order. The patient will restore the perception of the surrounding world and get rid of derealization.
Also, for VSD, symptomatic therapy is used to relieve panic attacks. It can be:
The main thing is to relieve the attack, which provokes derealization.
Other methods are also used. Effective in combating changes in the perception of the world:
With these signs, the onset of schizophrenia and other mental illnesses may occur.
Possible causes of vegetative-vascular dystonia: osteochondrosis, dizziness and headaches with VSD
According to statistics, about 30% of the working population suffers from vegetative-vascular dystonia. The reason for this is the accelerated pace of life, stressful situations, chronic fatigue and bad habits. Women are at greatest risk of getting the disease.
VSD can also cause osteochondrosis of the cervical spine, which in turn, according to doctors, is also a consequence of an unhealthy lifestyle. We’ll talk about osteochondrosis, as well as two other “favorite” companions of VSD – headache (cephalgia) and dizziness – in this article.
Headache with VSD
Vegetative-vascular dystonia is a symptom complex that is the result of dysfunction of the autonomic nervous system. The most common symptoms of such disorders are: weakness, dizziness, confusion, hot flashes, nausea with VSD.
One of the most common and striking manifestations of autonomic neurosis is headache or cephalgia. It can be debilitating and long, and cannot be relieved with painkillers. A person who suffers from a headache due to VSD feels exhausted and tired, and is constantly irritated. One of the main causes of headaches with vegetative-vascular dystonia is a malfunction of the autonomic nervous system, which leads to dysfunction of the cerebral vessels, but various examinations do not reveal any specific manifestations and pathologies in the functioning of the circulatory system.
Symptoms of VSD with cephalgia
Almost all people suffering from vegetative dystonia experience manifestations of cephalgic syndrome. Most often, the headache begins to hurt in the morning, immediately after waking up. The pain torments the patient throughout the day, neither weakening nor intensifying, and “releases” only at night, when sleep comes.
Headaches with VSD can affect the entire head or any part of it. Painful sensations can be pulsating, aching, bursting or dull. They may be accompanied by dizziness, fainting, nausea and vomiting, and sometimes visual disturbances - the appearance of glare, spots or spots before the eyes.
Migraines and tension pain are also characteristic of this disease.
Tension pain
Tension pain is a type of headache in which a person experiences squeezing and aching pain, usually occurring in the late afternoon. Symptoms of tension pain:
Migraines and VSD with migraine-like paroxysms
Migraine is a regular or episodic pain of a pulsating nature, usually occurring in one half of the head, less often in both. According to statistics, migraines most often affect women who hold leadership positions or are engaged in mental work. Main symptoms of migraine:
Dizziness with VSD
Dizziness is also one of the typical manifestations of the disease. In terms of prevalence, it ranks second after headache.
The nature of dizziness with VSD
There are two types of dizziness: true and false. With true dizziness, a person thinks that the objects around him are rotating or he has a false feeling that he himself is rotating. An example of true dizziness, which does not indicate the presence of any pathology, is the condition that occurs after a long spin on a carousel and its sudden stop. If true dizziness occurs without an external cause, then most likely it is caused by some organic disease.
False dizziness is described by patients as a feeling of instability, weakness with a veil before the eyes. Feeling dizzy with VSD is exactly the same as with false dizziness. Usually attacks of dizziness begin unexpectedly. Patients complain of blurred vision, loss of strength, and confusion. Often dizziness is accompanied by a pre-fainting state, in this case we are talking about VSD with syncope. Fainting with vegetative vascular dystonia usually lasts no more than 30 seconds.
Causes of dizziness with VSD
Typically, dizziness with VSD occurs due to stress or a traumatic situation. An excess amount of adrenaline enters the blood, as a result, the blood vessels of the brain narrow, and the brain itself experiences oxygen starvation, which leads to dizziness, lightheadedness and fainting. Dizziness and fainting with VSD of the hypotonic type are not uncommon. This is due to the fact that due to low pressure, a sufficient amount of blood does not flow to the brain, resulting in oxygen starvation.
Treatment of headaches and dizziness due to VSD
To eliminate and prevent the recurrence of headaches due to VSD, complex treatment is used, aimed at preventing panic attacks and fears; taking sedatives and herbal decoctions is aimed at restoring the nervous system. If headaches rarely bother a patient with VSD, doctors recommend procedures such as massage of the collar area, hirudotherapy and acupuncture. If the pain is regular and causes agony to the patient, he is prescribed medications designed to normalize blood pressure and strengthen blood vessels, for example, Nicergoline and Pyrroxan.
If the cause of vegetative-vascular dystonia is stress, the patient is prescribed psychotherapy. After just a few sessions with a psychotherapist, the patient may notice improvements in the body, gradually begin to feel better, and the pain in the head will go away.
In addition, a person who often has headaches should take the following preventive measures:
VSD and osteochondrosis
Cervical (as well as cervicothoracic osteochondrosis) and VSD are closely interrelated. Experts say that in almost 90-100% of cases, cervical osteochondrosis leads to vegetative dystonia. Let's figure out why this happens.
Cervical osteochondrosis is a degenerative disease in which the intervertebral discs in the cervical spine become thinner and destroyed, which leads to pathological changes in the spine: compression of blood vessels and nerves occurs, as well as the vertebral arteries through which blood flows to the brain. Due to compression of the arteries, blood circulation is impaired. The brain becomes vulnerable to stress; in addition, due to compression of the nerves and irritation of the nerve fibers, it begins to perceive the signals entering it worse. All these factors lead to the development of autonomic disorders. Thus, VSD in cervical osteochondrosis is a very common phenomenon. Osteochondrosis can be the cause of vegetative dystonia, and if it is treated, the symptoms of VSD will also disappear.
However, it also happens that a patient has both diseases, but osteochondrosis is not the cause of VSD, and the symptoms of dystonia are caused by some other organic disease. In this case, treating osteochondrosis will not be enough; in this case, additional identification of the causes of disorders and additional treatment of VSD is necessary.
Causes of development of osteochondrosis of the cervical spine
The exact reasons causing changes in the intervertebral discs are unclear. Most doctors believe that factors that can cause the disease are:
VSD and cervical osteochondrosis: symptoms
With VSD and cervical osteochondrosis, symptoms indicating the disease may be as follows:
Diagnosis and treatment
Only a qualified neurologist can diagnose and treat vegetative-vascular dystonia and osteochondrosis. He must determine the cause of the disease, which is not always easy. For this purpose, in addition to a visual examination of the patient, additional examinations are prescribed: MRI, computed tomography, Echo-CG, ECG. They will help to understand whether osteochondrosis is the cause of vegetative neurosis.
Treatment methods for osteochondrosis and VSD:
Osteochondrosis and autonomic disorders should be treated comprehensively, using all of the above methods.
