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As a result of disturbances of consciousness, there are problems with the reception of the surrounding world and oneself. There are several types of consciousness disorders, despite the differences in symptomatology, each of them should be thoroughly diagnosed - the cause of its occurrence may even be a life-threatening disease.

Causes of consciousness disorders

Each disturbance of consciousness that occurs in the patient is a significant problem, requiring full and detailed diagnostics. This necessity is associated with the multitude of causes of consciousness disorders, which may be:

  • poisoning (with alcohol, other psychoactive substances, but also drugs or heavy metals),
  • systemic infection (bacterial or fungal),
  • diseases of the central nervous system (hemorrhages, neoplastic diseases, abscesses located in the brain and craniocerebral injuries, but also epilepsy - disturbances of consciousness may appear especially in the period after an epileptic seizure),
  • water and electrolyte disturbances (e.g. dehydration, abnormal amounts of sodium or potassium in the blood),
  • diabetes (in this case, disturbances of consciousness can result from both excessively high glucose levels and insulin overdose resulting in hypoglycaemia)
  • hypoxia,
  • meningitis,
  • exposure to external factors - overheating or electric shock,
  • sudden withdrawal of regularly taken drugs (e.g. alcohol),
  • uremic coma.

The factors listed above are the most common causes of disturbed consciousness. However, the problem may also appear in many other disease entities, especially if they have an unbalanced and severe course.

Categorization and symptoms of disturbed consciousness

The disturbances of consciousness fall into two main categories: quantitative and qualitative disturbances of consciousness.

Quantitative disturbances of consciousnessare those in which the degree of perception of reality and oneself is narrowed down. The mildest in this group is blurring of consciousness (obnubilatio). Patients experiencing this condition are slightly confused, they may be delayed to answer questions, relative orientationtime is slightly disturbed in them. More severe are the symptoms associated with somnoletio (somnoletio), in which patients are able to answer questions they are asked, however, it may be necessary to repeat them many times before an answer is obtained.

Among the quantitative disturbances of consciousness there are also those in which verbal contact with the patient is not possible at all. One of them is half-coma (sopor), where patients respond only to pain stimuli. As you can guess, a more serious problem is the state of coma (coma), in which patients not only stop responding to factors that normally cause pain, but also lose their physiological reflexes.

A separate type isqualitative disturbance of consciousness . In their course, symptoms also concern aspects other than awareness, and they are divided into four symptomatic syndromes.

Consciousness Disorder - Delirium Syndrome

In delirium syndrome (also referred to as delirium), allopsychic orientation, i.e. awareness of the surrounding world, is most often disturbed in patients. Patients may not know where they are or what day of the week or month it is.

Self-orientation (e.g. as to identity, age), i.e. the autopsychic orientation, is much less likely to be disturbed. In the course of delirium, patients may experience hallucinations and delusions, and changes also affect their psychomotor activity - the range of disorders ranges from slowness to overactivity. It happens that patients are restless and even aggressive, they may also experience memory problems.

Disturbances of consciousness - onejroid syndrome

Onejroid syndrome, another qualitative disturbance of consciousness, is also sometimes referred to as sn like. Patients with this problem experience the complex hallucinations that guide their activities - patients' behavior can be compared to acting in a movie. Other ailments in people with oneroid syndrome are memory and psychomotor activity disorders.

Consciousness Disorder - Bindness Syndrome

Quite interesting from the point of view of the symptoms is the light-headedness syndrome (also known as obtuse syndrome). It is characterized by a significant reduction in consciousness and disturbed thinking (i.e. a change in the pace of thought processes). Patients may experience mood swings - it may be adjusted to their productive symptoms (delusions and hallucinations). The variations of the Breathing Syndrome are:

  • wandering drive,
  • so-calledfugue (a person suddenly, basically for no reason, escapes from his place of residence, sometimes this escape can lead the patient to another city or even country - after the fugue has ceased, the patient does not remember events from its period),
  • sleepwalking (sleepwalking).

Consciousness Disorder - Confusional Syndrome

The last type of qualitative disturbance of consciousness is the confusing (amentive) syndrome. In its course, both allo- and autopsychic orientation are impaired - patients do not know where or who they are. Verbal contact with a patient with the Confusional Syndrome is impossible, and disorderly motor activities (e.g., nibbling sheets) may be noticeable. Patients may experience productive symptoms, but their identification - due to the lack of verbal contact - is much more difficult. After stabilizing the clinical state, the patient does not remember events from the period in which he was in the amentive syndrome.

Diagnosis and treatment of consciousness disorders

Identifying disturbances of consciousness is difficult as it is usually impossible to obtain more accurate information directly from the patient. In medicine, it is commonly said that most disease entities can be diagnosed on the basis of a personal examination (medical interview) alone, but in the case of the discussed group of problems, such a possibility rarely exists. Doctors are not, however, helpless.

In the diagnosis of consciousness disorders, imaging tests (e.g. computed tomography or magnetic resonance imaging, but also X-rays) are performed, laboratory tests are also invaluable (basic, such as urine assessment or blood counts, as well as those assessing markers of inflammation or blood glucose or urea levels). The exact selection of tests depends on the suspected etiology of consciousness disorders - a patient with evident traces of a trauma will be treated differently, and a person whose presence of consciousness disorders is associated with the exacerbation of a disease, e.g. diabetes, will be treated differently.

The treatment of consciousness disorders is primarily causal. They are always preceded by the detailed diagnostics mentioned above. If electrolyte deficiencies are detected in a patient, the procedure is based on supplementing them, in the case of dehydration, fluids are administered, and in the event of an infection, pharmacotherapy appropriate to the infection is administered. Sometimes medications are used that are administered to temporarily relieve the patient's symptoms - this is the case, for example, in delirium syndrome, where patients are sometimes given drugs from the group of neuroleptics or medications.anxiolytic.

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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Category:

Neurology