It is known that delirium is called a mental disorder, which occurs under the influence of a large number of reasons.They can be divided into two groups - endogenous and exogenous.
Exogenous causes include all the external factors that contribute to disruption of brain activity and lead to a change of consciousness and perception of the world.This is primarily alcohol, drugs, toxic substances and poisons.This includes viral and microbial intoxication, traumatic brain injury.
endogenous, ieinternal factors tend to be associated with the violation of the internal organs and the various body systems.Among this large group are a number of genetic abnormalities, accompanied by mental disorders, hereditary diseases.
Delirium usually occurs in mild and moderate form, but in some cases it becomes difficult for the patient and is a threat to life.While perceiving them as really existing in the illusion of inclusion of unreal objects - While in a state of delirious patients have complex hallucinations, they ca
Patients often present sound, visual, tactile, motor hallucinations, they often exacerbate the picture of delirium and cause additional pain to the patient.Emotional state in different types of this disorder may be different, but in many respects depends on the nature of illusion.
often disturbed intellect, memory, thinking in this pathology.And while all of these state under the influence of treatment are, they leave a trail for a long time in the patient's health.
After the release of their delirium is still a certain time may be some confusion, however, all the memories of the events taking place in an altered state, almost completely erased from memory.
What types of delirium
Clinical manifestations of delirium are very diverse and sometimes difficult to distinguish one species from another.
- actual delirium;
- complete disorientation and self at night can go into delirious state - amentia;
- oneiric condition - complicated the distortion of perception, in which there is a disorientation in space and in the self, and the present Dreamscapes, which becomes a direct participant in the patient himself.
Types of delirium are also distinguished by quantitative disorders:
- stunning - kind of disturbance of consciousness, in which there is a strong inhibition of responses to external stimuli, developing sleepiness, poor orientation in the surrounding area.After leaving the memory state may be lost to the events.In case of unfavorable development of symptoms are exacerbated, and develops stupor or coma;
- stupor - predkomatoznoe condition in which a person covers stupor, going deeper disturbance of consciousness - there is practically no reaction to the surrounding people and the events, questions the patient does not respond, the physical effects and does not respond;
- coma - the extremely serious condition of oppression of consciousness, in which completely absent reaction to any stimuli.On the organ level occur respiratory disorders, circulatory, urinary, etc.Without a connection to the artificial respiration and circulation, these patients die.
In practice, delirium is divided into several types:
- senile (on background of dementia);
All the phenomena of delirium time, they only reflect the depth of the central nervous system, the degree of disturbances in metabolism.In some cases, delirium is a signaling system of the body, which indicates that the body is completely exhausted their resources and can no longer cope with the toxic effects of exogenous and endogenous factors.
Clinical manifestations of some types of delirium
first step is to specify the general for all kinds of changes in the state of delirium:
- excited state, anxiety, fear of death, motor and speech excitement;
- inability to sit still in one place, a constant desire to take a new position;
- gradually exacerbated by a change in the spatial and personal orientation;
- tempo change its speech intelligibility and, in later stages, patients no longer come into contact and react to stimuli;
- disturbed perception of reality may be present highly complex, saturated true and false hallucinations, auditory, tactile, visual, motor character.
the internal organs and severe changes.Thus, broken processes of urination may develop oliguria (low urine output), vasospasm occurs, to which the body reacts sweating, high blood pressure, tachycardia, weakness, fever may be wavy.
Almost all patients have muscle weakness (atony), trembling lower jaw, trunk, extremities.The motions are small, low-amplitude movements.Tremor can be so severe that the patient literally shudders convulsing.In addition, frequent enough satellite all types of delirium are convulsions, they can often be caused by rising cerebral edema.
Infectious delirium often develops at the peak of the infection process.Very often it causes are severe pneumonia, typhoid, childhood infections.In some cases, delirium does not appear suddenly, it may be a harbinger - increased anxiety, excessive activity in bed, patients can not lie, break through all the time to get up, develops anorexia, some patients become very sensitive to bright lights, loud noises.All these phenomena occur against a background of extremely high temperatures.
In the evening, usually there is a strengthening of symptoms, the patients begin to cry, their speech is incoherent, movements become erratic, sometimes develops rampant fear that causes patients to jump out of bed and run away from the imaginary pursuers.He listens and gets accustomed to the surrounding, it is absolutely not oriented in its location, but questions about himself responsible quite clearly and correctly.By morning symptoms subside, the mind may be clear, but with the advent of all the repeats of the night.Without treatment, patients can completely exhaust your strength and die of exhaustion of all organs and systems.
Mussitiruyuschy delirium called the silent disorder of consciousness, which develops in severe internal diseases.It can also be in alcoholism, poisoning by heavy metals, some drugs, such as sulfa drugs, atropine.This kind of delirium relatively quickly goes into stupor, and without the timely assistance and to whom.
patient on the background of the height of the disease develops increased physical activity, which, however, does not extend beyond the bed.The patient does not record view, it does not answer the questions and not respond to external stimuli.His speech was incoherent and quiet, there are small twitching in his hands.In most cases, patients develop brain swelling.The duration of this form of clouding of consciousness can be from one or two days to a week.
old man's delirium (senile delirium), as the name implies, develops in old age, accompanied by a sharp decline in intelligence, the loss of all previous knowledge and skills, as well as poor visual hallucinatory experiences and performing repetitive movements characteristic, such as their last professional activity.It such patients often quiet and obscure.Basically it develops against the backdrop of serious physical illness.
Dementia - Dementia acquired with age, the main causes of which is the huge list of diseases from multiple sclerosis and hypertension to alcoholism and craniocerebral trauma.When dementia occurs disintegration of the patient's personality.Delirium on dementia often develops gradually, but in most cases developed dementia is an impetus for the development of delirium.
Often, people suffering from senile delirium, more active at night day, typical for them unexpected fees for any fictional relocation.However, the symptoms of delirium often go unnoticed, they blamed on the existing dementia.
Patients usually complain of fatigue during the day, poor concentration, anxiety or depression.A s the first signs are often nocturnal nightmares that patients differ little from reality.Many old people in a state of delirium appear illogical thoughts, they are not able to think critically.Symptoms can vary even during the day, but the deterioration still occurs at night.Gradually, the lucid intervals are getting shorter, and there comes a time when they did cease to appear.
Postoperative delirium is one of the quite rare complications after a major operation, more common in elderly patients.A risk factor may be general or regional (epidural) anesthesia, a long period of the operation, violations of water-salt metabolism (hypernatremia), a large blood loss, a history of alcohol abuse, cardiovascular disease.Delirium can develop both on the type of excitation and inhibition with neuropsychiatric features or have mixed symptoms.
Delirium tremens - a mental disorder in which the developing state of delirium, hallucinations, fever and heavy sweats with chills.Hallucinatory paintings are aggressive, intimidating character, in which there is an imaginary threat to the patient or the people around him.visions are often mixed, so visual images can be combined with auditory and tactile hallucinations false.The patient is very excited and can not adequately respond to the others, while he does not consider himself sick, and their behavior strange.The main danger of this condition is that the patient can put yourself injury threatening to life.
Delirium tremens never develops on the background of alcoholic intoxication, but after abstinence for several days of drinking, the chance of developing delirium is very high.Thus, it is abstinence delirium most typical 4-5 day from the moment of refusal of receiving the usual doses of alcohol.Pretty typical manifestation of delirium tremens is its origin in the evening or night.Symptoms can appear immediately, but can also be extended in time display of all symptoms.