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Distraction of consciousness

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The confusion of consciousness is a disintegration and complete unorganized activity of the psyche, expressed in the altered quality of the composition of consciousness. For the first time, a clear and darkened consciousness was described by K. Jaspers. Combining the characteristic features in which there is an alienation from the true external content, a fragmentary, fuzzy perception of the surrounding. The person is disoriented at the location of his stay, the time of the event she is not able to identify. Often the personality is disoriented situationally. Sometimes, even an individual does not have the ability to determine the orientation in his own person. The structure of thinking is broken, down to complete incoherence. The moment when the person was in a darkened state is completely amnesized. All these disorders belong to a psychotic or productive form. This symptom does not arise without cause, its danger is undeniable, it is necessary to find out the problem urgently.

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Symptoms of the confusion of consciousness

The confusion of consciousness is caused by various factors, including head trauma, circulatory disorders, any changes in the body, tumors, differentiation with blood glucose, destructive diseases, severe shocks, brain infections, intoxication infections, overdose of various drugs.

The confusion of consciousness appears suddenly, its duration is variable, more often this is a fairly short time. Behavior is different, can be characterized by excitation, both motor and acceleration of thinking and speech. Affective states are possible, for example, fear. Some patients, especially with epilepsy, can be very dysphoric, and their violence is completely without cause and after the exit they will forget everything. The confusion of consciousness is accompanied by the non-acceptance of other people.

The forms of obscuration of consciousness depend on the underlying pathology, with alcoholism and other intoxications, delirium mainly arises. Twilight is characteristic of diseases of the brain. A onyeroid often comes out of delirium or is also intoxicated with it. The person is agitated, but there is also a calm state, disorientation comes immediately.

The confusion of consciousness is accompanied by a complete lack of response to external stimuli, because the consciousness of the person is overflowing with productive psychotic symptoms. At the same time, it is visually revealed that a person is unaccustomed to the habits, he can look closely.

Distortion of consciousness is accompanied by the 4th signs simultaneously:

- Alienation from the environment;

- Pathology in the orientation of personality;

- Thinking is amorphous, broken and fragmented;

- Amnesia of events following obscuration.

It is often possible and delusional ideas that are easy to spin. Criticality at the same time is quite high.

Paroxysmal obscurations of consciousness are short-term, sudden obscurations that can be repeated. At the same time each time they are similar to the previous ones. The main cause is mainly epilepsy and diseases with similar symptoms. It is important to consider that with every convulsion, a part of the brain will die. Such paroxysms arise suddenly and are always short-lived. Among them, seizures, absences, dysphoria, the equivalent of convulsions can be selected. Confusion of consciousness is also possible with hysteria taking place in severe form, and, rarely, in panic attacks.

Types of darkening of consciousness: delirium, onyeroid, twilight, amenia, it is also important to distinguish from the deactivation of consciousness.

Twilight confusion of consciousness

Appearing suddenly, twilight also instantly passes. Paroxysmal obscuration of consciousness has exactly the same course. At twilight confusion, disorientation is very pronounced. A person runs somewhere, can go from the usual place, and wake up 40 km from the house. He does not remember where he went, what he did and how it happened. Then it is called a twilight state without delirium, affect and psycho products. All movements are automated, hyperkinesia with automatisms. Consciousness is narrowed to a narrow circle of real objects. Optional symptoms: marked emotional affect, vivid hallucinations, experiences of illusions are possible. There may be incoherent speech, a brief, intense, sensual nonsense. Behavior is destructive-aggressive state. At the exit is always dementia retardnogo nature.

Forms of obscuration of consciousness of this type can be subdivided into several subspecies. Types of obscuration of consciousness include such variants: typical, hallucinatory, delusional.

A simple variant is characterized by outwardly unconcerning habits of patients. Their appearance is generally correct. There is estrangement, sometimes sullenness, with the appearance of spitefulness on the face. Many people have a complete loss of speech, a type of mutism, they are silent, tense, if they say, then stereotypically and illegibly. In this episodic appearance of psychoactive symptoms. The end of psychosis is critical, getting out often through deep sleep.

The hallucinatory variant in practice is inherent in patients with epilepsy. Psychosis arises from illusions, then hallucinations arise, which act on all analyzers. Most patients observe horrific pictures, this forces them to attack and defend themselves. In cases of heavier, there is confusion with incoherence and a craving for murder. These are very dangerous patients, they are unreasonably aggressive. They sometimes recognize relatives, are simply spiteful and scared, so this type is oriented, or dysphoric.

The delusional version is also accompanied by orderly behavior, with no view at all. They are very focused and silent. Having come to self-consciousness, they perceive their actions as strangers. If you ask, you can pull crazy ideas.

Fugues are very brief states of outpatient automatism. The patient, unexpectedly for everyone, undresses, starts running, turns in a circle. All this lasts 1-2 minutes and passes also suddenly. The patient does not realize what happened to him.

Delirious confusion of consciousness

Acute psychosis from confusion of consciousness, accompanied by scenic hallucinations. Hallucinations are projected outward, true, and illusions are possible. Orientation in space and time is absent, but in its own personality it is completely oriented. The man is psychomotor-agitated. Patients are so deep in their own hallucinations that they do not immediately hear a speech to them. Can not understand the situation. Thinking is inconsistent and chaotic. After the completion of psychosis, amnesia is partial and the person perfectly remembers hallucinatory images, but badly - real events.

In the course of delirium, there are 3 stages:

- Initial, disorientation appears with increasing disturbances in sleep. Awakening, the patient is not able to distinguish between his nightmares and reality. Begin the influx of memories, which can not be seen clearly. A constant symptom is mental hyperesthesia with emotional instability, fussiness and distractibility. The symptomatology intensifies in the twilight hours. Speech is accelerated, right up to the patter and incoherence.

- Pre-stage stage, illusory disorders, alternation of "lucid windows" when the person is conscious and allopsychic disorientation."Lucid windows" often appear in the daytime, and in the period of disorientation there are illusions. Real details turn into fantastic figures and faces. If patients want to sleep, they interfere with hypnagogic hallucinations. In this case, the symptomatology is exacerbated earlier.

- True delirium, all symptomatology is maximum expressed. Complete insomnolenka. Hallucinations are true, auditory, visual, very frightening. There are also tactile hallucinations, up to combined perception deceptions, which affect all senses. These are scenes of the opposite for the sick composition, aggressive actions are possible, as a reaction to a hallucinatory experience or committing suicide. Duration of delirium is several days, sleep is absent.

The regression of delirium differs between critical and lytic. Critical passes through a deep, prolonged sleep, after sleeping asthenia. With the lytic - the delirium returns back, having passed 3 stages. If the clinic does not go beyond the 1st stage, then the term predelilion has the meaning. Possible abortive delirium, reaching up to the second stage. A variety is hypnagogic delirium. There is also a mustering delirium and a professional one. Etiology leads to a certain specificity. When poisoning with opiates - micro-pores, organic solvents - fantastic hallucinations, tetraethyl lead - oropharyngeal hallucinations.

ONEIROID DEPRIVATION OF

CONSCIOUSNESS ONEIROID obscuration of consciousness proceeds with the patient's absolute estrangement from the world around him. He sees bright hallucinations, as if looking at the fascinating film. Hallucinations are like a film on a delusional scenario.

There is always a depressive or manic affect with an onyroid. Catatonic stupor can spread. Perhaps the excitement with amnesia experienced. With the onyroid, self-consciousness changes and one's own self reincarnates. The person is externally immobilized, but there is a sharp dissociation, because in his head there are rapid dynamic events.

Before an onyroid, acute sensory disturbances arise-delirium of intermetamorphosis. Antagonistic delirium is very common. The clinical picture develops because of the strengthening of uncontrolled fantasies with the presence of vivid ideas. Fairy-tale events are experienced simultaneously with the real, that is, they have a double orientation. This is only the beginning, which has the terminology oriented onyroid. In the measure of the deepening of the pathology, a dreamlike dimming of consciousness develops. Outside, such patients are completely alienated from the objective world, they follow the fantastic composition of their experiences, the modification and the subsequent transformation of their own "I".The expression of the face corresponds to the kind of inner experiences - there may be joy, surprise, fear, horror, numbness. Depends on experiences that have a different type of character possible to think about an illusory-fantastic or delusional onyroid. It is absolutely obvious that the basic behavior and perception correspond to the existing defect. A man comes to his senses gradually, catatonia and absurdities in behavior can be observed for a long time. However, there are no non-negotiable changes in the person.

Amenic obscuration of consciousness is the most profound confusion of consciousness. The basis of the amenation is a profound, complete disintegration of the entire activity of the psyche, so the person is grossly and totally disintegrated, attention is disturbed, especially active, the incoherence of thinking, psychomotor agitation is aimless, changes to immobilization. Perhaps the presence of psycho products, right up to agitation. At the same time, the person is constantly twitching, which is similar to the trochaic twitching. After the completion of this condition, the person has a full amenity. At the end, there remains an expressive defect, up to dementia or a prolonged debilitating asthenia.

Treatment of the confusion of consciousness

For all types of obscuration of the consciousness of the individual it is necessary to deliver to the appropriate institution, while the person should not remain alone. Due to their visions, they are dangerous both for themselves and for those who are around. Only a psychiatric institution is able to provide proper supervision. Transportation of these patients is not easy, because they are nervous and often aggressive. At the same time, they have a lot of strength. Without antipsychotics and medics, it is better not to go to them. It is important to have at least 3 trained people, if the patient has a weapon, law enforcement agencies should be called.

In the presence of the underlying disease, which leads to dull conditions, it is important to treat it precisely. Especially if a person has a severe infection and he burns. Treatment to apply in a complex, the main thing is not to overload the cardiovascular system.

It makes sense to introduce drugs that work with psychotic stimulation. Seduxen 0,5% r-40-60 mg w / m, Aminazin2,5% r-2-4 w / m, Amisulpiride 150-200 mg through the mouth, Lamotrigine 100-200 mg / day.

Coping of delirium in alcoholics. To stop the excitement, hallucinations and insomnia complex: tranquilizers Sibazon 0.5% 2-4 ml IV or IM, Relanium 2-4 ml IV or in / m throughout the day. Soporific: Sodium Oxytobutyrate 20% 20-30 ml IV, Ridazine 150-400 mg / day. Detoxification - Cytoflavin 0,1% 10 ml 2p / day or Lysine 5-10 ml dissolve in physiological solution. Glucose 10% 400 ml with Insulin 10 units. Sodium thiosulfate 30% 20 ml iv 2 r / day, Atoxyl 12 mg per 250 ml through the mouth 3 r / day.

Vitaminotherapy - Thiogama 600 mg / day. Cardiovascular preparations: Korglikon 0.06% 1 ml IV, Strofantin 0.025 2-3 mg IV.If blood pressure is lower, then apply Cordiamine 2 mg IV, Polyglukin 200-400 ml IV.For the control against acidosis of blood Sodium bicarbonate 4% rr 200-400 ml w / m throughout the day. Confrontation with the threat of cerebral edema: Lasix 1% 2-4 ml 1 p, Mannit 15%, Manitol 200 ml 1 time. Control of electrolyte exchange: Magnesia sulfate 25% 10 ml.

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