Impaired consciousness - Causes, symptoms and treatment. MF.
Apr 17, 2018
Human consciousness is the highest mental process that provides cognition and reflection of the objective reality of the world and the person himself and adaptation in the world around him. Sudden disorders of consciousness represent a real threat to life.
Syncope( syncope) are attacks of short-term loss of consciousness and violations of postural tone with a disorder of cardiovascular and respiratory activity, that is, with violation of vital functions.
Syncope develops as a result of acute disruption of the metabolism and circulation of the brain, leading to hypoxia of neurons. The person suddenly falls unconscious. Perhaps the presence of a brief aura - darkening in the eyes, a feeling of "faintness", weakness.
Many syncopal conditions are part of emotional stress and are primarily neurogenic in nature. They can also be in a healthy person under extreme conditions, exceeding the limits of physiological possibilities for adaptation and tolerance of unusual habitat conditions or extreme effects - at the sight of blood, at a dentist's reception, a fast night's rise, a long standing, physical overload, hyperthermia.
A significant lack of oxygen in the ambient air( at height, in a sealed chamber) will cause a disturbance of consciousness. Increased emotional and vascular reactivity determines the nature of the response of the body to stressors. Risk factors for the development of "emotional" faints are neuroses and neurosis-like conditions, especially hysteria, neurasthenia, pain, fear or horror in connection with real events - accidents, catastrophes, natural disasters, crimes. Personally significant content of emotional impact for this person will provoke a faint - the death of a loved one, the news of a funeral, divorce, the failure of the exam.
However, fainting may be a manifestation of severe somatic and neurological diseases that threaten life - brain tumors, aneurysms of cerebral vessels, heart disease. Neurocirculatory dystonia, cerebrovascular atherosclerosis, vertebrobasilar insufficiency, pathology of vertebral and carotid arteries may be the cause of syncopal conditions. Arrhythmias and heart block, myocarditis, ischemic heart disease, hypertonic and hypotonic disease can cause fainting. Infections, intoxications( poisoning) of domestic and industrial poisons, allergic reactions, blood diseases, massive blood loss, diabetes, lung diseases can cause disturbances in consciousness.
Epilepsy is a group of diseases with sudden convulsive seizures and loss of consciousness. With epilepsy, it is possible to develop various seizures with various variants of impaired consciousness: twilight confusion, somnambulism, trance, absence, psychosis, delirium, hallucinations.
Epileptic seizure - loss of consciousness and tonic-clonic convulsions
Epilepsy may be an independent disease, but may be a symptom in another disease - brain tumors, stroke, brain injury, intoxications( alcohol and narcotic).Most often a person suddenly screams, falls, struggles in convulsions, the body arches, foam comes from the mouth, the tongue bites, perhaps involuntary urination. After the attack, the patient is drowsy and does not remember anything.
The stunnedness of is characterized by the restriction of verbal and verbal contact, an increase in the threshold of perception of external stimuli-sound, light, pain, and a decrease in one's own motor activity. With deep deafness there is drowsiness, a disorientation in time and place, it is possible to perform only simple instructions. Perhaps the combination of stunnedness with hallucinations, delirium, dilated pupils, tachycardia, tremor, increased blood pressure. The most common reason for such delirium( mental disorder that occurs with a violation of consciousness) is alcohol abuse, high body temperature, intoxication with some medicines( psychostimulants, antidepressants, sedatives), oncology, severe neuroinfections( meningitis), head injuries.
- the heavier violation of consciousness, when only protective reactions remain, opening the eyes in response to pain, sound and other stimuli, episodic short-term minimal verbal contact - the patient opens his eyes at the request of the doctor, raises his hand.
Coma is a complete shutdown of consciousness. The degree of severity is divided into three degrees - moderate, deep and supernumerary. Coma can develop with diabetes, kidney disease, heart disease, cerebral stroke, head injury, poisoning. Diagnosis of the cause of development of com and their treatment is the work of professionals - resuscitators. The depth of the coma is evaluated according to the special scale of coma - Glasgow, which takes into account visual, speech, motor reactions. Score range: 15 - clear consciousness, 3 - 4 points - coma of the grade. The task of others just to quickly call an ambulance and deliver the patient with any violation of consciousness in the hospital.
Confusion of consciousness - disintegration, perversion of mental activity, in which the reflection of the world is distorted. In the case of an anoroidal obscuration of consciousness, the patient is detached from real events, experiencing fantastic threatening illusory events. With delirious obscuration, true visual hallucinations are present while maintaining the orientation in itself. With an abnormal obscuration, a total violation of all mental processes occurs. Distortion of consciousness is the field of psychiatrist research.
The hallucinations of
The importance of consulting a doctor for any impairment of consciousness is determined by the severity of the particular manifestation of the disease, the frequency, the risk of additional trauma during a loss of consciousness, the real risk to others, if the patient during the attack controls the transport, works at height, with open fire,.
Inspection in case of impaired consciousness and to which doctor to apply
Mandatory examinations in case of mental disturbance( of course, if the patient does not immediately get into serious condition in the intensive care unit) there will be examinations of the neurologist, oculist, therapist, electrocardiogram, electroencephalography, computed tomography,resonance therapy, biochemical examination. Further tactics depend on the results obtained. A single syncope in case of overheating in the sun or orthostatic with a sharp night stand does not require special treatment. Neuro - circulatory dystonia with faints requires observation and treatment of the neurologist. If a brain tumor is detected, the patient will be referred to the neurosurgical department. Brain stroke is treated in the neurological department. Myocardial infarction, cardiac arrhythmias require treatment and supervision by a cardiologist. Epilepsy is treated with a neurologist, and with the presence of personality disorders in a psychiatrist - an epileptologist.
Consultation of a doctor ao topic of consciousness disorder
Question: how to render first aid in fainting?
Answer: check the presence of the pulse, chest movements, that is, breathing, raise the legs to improve the flow of blood to the head, release from the restraining clothes, bring the cotton wool with ammonia and wiggle in front of the nose, rub a cold cloth with whiskey and palms, provide fresh air. If fainting lasts more than 2 minutes, call an ambulance. When restoring consciousness, consult a doctor for examination and establish the cause of unconsciousness.
In case of an epileptic seizure, it is necessary to hold the patient's head in order to prevent a traumatic brain injury, if possible turn it to the side so that saliva flows out of his mouth. The attack will take place within 1 - 5 minutes. It is necessary to call an ambulance.
Doctor neurologist Kobzeva S.V.