Hallucinations are abnormal perception, which manifests itself in the form of certain images or sensations that occur arbitrarily without affecting the real stimulus or object, gaining for a sick person the character of objective reality.
Hallucinations in the elderly are an integral part of many psychiatric syndromes and accompany a variety of mental illnesses.In addition, hallucinations after a stroke, when the exchange pathologies and disorders in neuro-psychic sphere - a fairly common phenomenon.The mechanism of hallucinations before the end of the obscure, but clearly know that the basis of their origin is a pathology of the structures of the brain that are responsible for the perception of stimuli of the surrounding world and the formation of a response to them.
hallucinations Hallucinations in the elderly in relation to the subjective reality are divided into true and pseudohallucinations.True hallucinations are:
- spontaneous - occur without stimulus;
- reflex - occur in one analyzer in a real annoyance of the other;
- functional - occur during stimulation of the corresponding analyzer, but are perceived by patients in a curved form.
Depending on in which there is abnormal perception analyzer, hallucinations divided into visual, olfactory, with impaired hearing, taste, and tactile sensitivity, and other vestibular.It is worth noting that occur most often auditory and visual hallucinations, which appear geometric shapes, fotomamy (light flashes) or more complex forms (patients can see the fantastic beings, various objects, people, plants and animals).
What causes disease in elderly patients?
appearance of any hallucination represents a significant infringement of mental activity that can develop when:
- various mental pathologies such as epilepsy or schizophrenia;
- psychosis infectious origin;
- hallucinations on the background of an acute or chronic intoxication;
- with organic brain damage, especially in the presence of tumors;
- under the influence of hallucinogens;
- when taking certain medications (some antibiotics and antiviral drugs, sulfonamides, drugs used to treat tuberculosis, anticonvulsants, antihistamines and antihypertensive drugs, stimulants, tranquilizers and many others);
- with sensory and social isolation;
- temporary visual hallucinations in the elderly may be determined by taking medications with psihodisleptichnimy properties;
- in disorders in the mechanism of sleeping and waking periods.
should be noted that psychiatric symptoms among elderly patients is observed in different states.Clinical manifestations of these disorders depend on the underlying disease.
Acute onset senile hallucinations characteristic of delirium, it can also develop in different somatic diseases, as well as substance abuse, or when taking certain medicines that can cause psychosis.Chronic occurrence of hallucinations and sustainable characteristic of chronic schizophrenia, as well as psychoses, developing on the background of chronic somatic disease or Alzheimer's disease.
In addition, there are often hallucinations in Parkinson's disease.So, in approximately 20-60% of patients develop psychotic disorders.They are in most cases caused by external influences, although they can also occur in internal disturbances, for example, in the development of neurodegenerative process that develops in the nerve cells responsible for dopamine synthesis.
It is worth noting that the majority of anti-Parkinsonian drugs in the wrong reception may cause the development of psychotic symptoms.In the treatment of hallucinations that occur against a background of Parkinson's disease, it is necessary to remember that people in advanced age have an increased sensitivity to antipsychotics.In this case, the drug of choice in most cases becomes clozapine.
addition, can be used cholinesterase inhibitors, which lead to the reduction of psychotic symptoms and improve cognitive function in this pathology.It is worth noting that there are a number of factors that increase the risk of hallucinations in the elderly:
- damage to the cerebral cortex in the frontal or temporal region, which are caused by age-related changes;
- neurochemical disorders associated with aging;
- social isolation of the elderly;
- failure of the senses;
- pharmacokinetic and pharmacodynamic age-related disorders;
- polypharmacy, which can also become a cause of hallucinations in the elderly.
Principles eliminate hallucinations
If you are having hallucinations at the grandmother or grandfather, prehospital important to ensure the safety of both the patient and others, since it is often the behavior of people with hallucinations include actions that pose hazard that can cause significant injury.
Acute symptoms of hallucinations without fail must be repaired in the hospital.For a thorough examination of the patient need examination by a neurologist, psychiatrist, psychiatrist and oncologist.
How to treat hallucinations should be determined on an individual basis.Elderly patients treated hallucinations should be carried out taking into account the etiology of their origin and parallel treatment of the underlying disease.Most often appointed antipsychotics and neuroleptics.At their reception, the following side effects:
- extrapyramidal disorders - dystonia, dyskinesia, akathisia;
- anticholinergic effects that include dry mouth, constipation and difficulty urinating;
- postural hypotension;
- changes in the digestive system and liver;
- weight gain and disruption of the pancreas, which can trigger the occurrence of acute pancreatitis and pankreanekroza.
is why hallucinations in the elderly should be treated under medical supervision with strict observance of the prescribed dosage.When hallucinogenic syndrome is also shown receiving sedatives and tranquilizers, detoxification drugs.After calming down of the acute manifestations shows the psychosocial and cognitive-behavioral therapy.
Any attempt to explain to the patient that he was the victim of hallucinations, do not bring any positive effect - a man completely lacking a critical attitude to his condition, and he is not aware of the harmfulness of these phenomena.That is why in case of hallucinations in elderly patients may be hospitalized in a hospital psychiatric unit, without their consent, only in the direction of the doctor, watching him constantly, or at the time of the attack.