Distracted consciousness. How is specific sclerosis treated today?

The earliest manifestations of confusion and disorientation include a sharp decrease in concentration. During progression, there is a complete disruption of sensitivity to the outside world, memory lapses occur, logical thinking is modified, the patient does not understand what is happening, recognizable memory and full-fledged speech are impaired, and emotional distress occurs. As a result, depression, silence and inactivity of a person are recorded. The psychiatrist must distinguish between these aspects and provide a presumptive diagnosis when communicating with the patient.

What is a confused state?

In this process, the ability to think at an average speed disappears, the clarity and consistency of thoughts is significantly destroyed.

Content:

• What is a confused state?
• Causes
• Symptoms
• What is disorientation?
• Current of development
• Medical classification
• Symptoms of the disease
• Benefits of diagnostics

Signs of the disorder are problems with orientation in space and deterioration of attention. Logical thinking disappears and memory is degraded. The highest signs of the psyche change one by one. For example, only speech recognition may be affected. Memory problems are noted, spatial orientation is impaired. There are two types of confused consciousness, depending on the cause of its occurrence - fast and slow.

Manifestations can be one-time or permanent. Dementia and delirium are signs of the latter condition. The integrative function of thinking at the moment of confusion is absent. Along with the expected change, the patient is often silent, moves little, and is depressed outwardly. Illusions and hallucinations accompany the disease. The first arise because the body incorrectly perceives the stimulus, while hallucinations manifest themselves independently. Each person suffers from the disease differently - the determining factor is the underlying cause of the development of the disorder. Slowness of thinking and inconsistency of logical series are emphasized during the first minutes of conversation. Even non-professionals can notice the initial symptoms.

Psychotherapists divide delirium into several classifications: hallucinatory (the ability to see non-existent information); manic (obsession with aggression); catatonic (inability to fully move); confabulatory (twisting of an obvious fact).

Oneiroid (dream disorder)

A person is completely detached from the outside world, his visions are a kaleidoscope of illusions that are closely intertwined with fragments of reality. As a rule, the development of oneiroid is preceded by severe depression and mania. Involuntary fantasies appear on any topic, and subsequently some people describe their illusions in sufficient detail, and sometimes amnesia occurs, followed by complete or partial restoration of memory.

Visions are associated with travel, divine transformations, global disasters, meetings with alien civilizations, etc. Outwardly, the violation manifests itself as detachment from what is happening around. Facial expressions usually correspond to imagined experiences, but unlike delirium, the person remains motionless.

Sometimes oneiroid is accompanied by somatic symptoms. The temperature may rise to febrile levels. Sometimes there are complaints of pain in the back, heart, throat, and general deterioration in health. After relief of the acute condition, lethargy, weakness, and irritability persist for 10–14 days.

Causes

The following reasons for the occurrence of the phenomenon of confused consciousness are identified:

• traumatic (consequences of penetrating traumatic brain injury);
• in case of brain injury (organ tissues are highly sensitive);
• the occurrence of an aneurysm (an enlarged blood vessel affects neighboring tissues);
• mercury poisoning;
• increased dose of alcohol in the blood;
• drug intoxication;
• effects of neurotropic gas on the respiratory system;
• entry of organophosphorus compounds into the digestive system;
• poisoning with neurotoxic substances – puffer fish, mushrooms, carambola;
• hyperthermia resulting from infectious diseases;
• pain shock during a fracture, dislocation, significant blood loss;
• severe diseases - tuberculosis, encephalitis, diabetes mellitus, all types of hepatitis, acquired human immunodeficiency syndrome at the final stage of development;
• progression of the growth of a cancerous tumor at the last stage - decay (during the process intoxication occurs);
• coronary heart disease, all types of strokes, occurring both unnoticed and obvious;
• myocardial infarction, with pronounced pain and impaired blood flow;
• vegetative-vascular dystonia – dilation of blood vessels occurs in areas of the autonomic nervous system of the body;
• age-related diseases: senile dementia, Alzheimer's disease, marasmus of all types;
• bright emotional outburst;
• hypothermia;
• a period without sleep for a long time;
• oxygen starvation;
• 1st and 2nd degree stunning.

First aid

If consciousness is impaired, it is necessary to provide adequate first aid and, if necessary, call an ambulance. It is important to consider that signs of disorientation may indicate the development of serious illnesses. Sometimes confusion is a sign of a developing stroke . If there is such suspicion, a doctor should be called immediately. If a person has difficulty breathing, they need to remove tight clothing and provide fresh air. It is better that before the ambulance arrives, the patient is in a lying or sitting position and does not change it.

Symptoms

For a primary diagnosis, it is necessary to detect the active progress of processes:

• shallow memory lapses (information is lost within a few minutes);
• the patient cannot recognize his loved ones, as well as basic passport data;
• there is no memory of the person’s information field;
• disorientation;
• unconditional changes in mood (an aggressive mood can manifest itself even among close people);
• there is no logical chain in the pronunciation of phrases (pronunciation speed is below average);
• lack of control over the bladder and sphincter (constant urination and defecation);
• Normal sleep is completely disrupted.

Sometimes the cause of such manifestations is cervical osteochondrosis. The clinical picture in this case changes - pain in the cardiac and chest region is added, movement is limited, and there is increased sweating.

Due to internal bleeding, additional aspects appear: excessive sweating; pale skin; black stool; high blood pressure; worsening breathing; tachycardia.

Psychological disorder, in turn, entails inappropriate behavior, aggressive attacks, lack of normal sleep, terrorizing the immediate environment, the emergence of helplessness and the collapse of a clearly established internal model of behavior.

If the patient experiences the changes described above, you should immediately contact your local psychiatrist. Next, a conversation is held, but not in private, but in the presence of a relative. Additionally, blood donation is prescribed for general and biochemical blood and urine tests. An electrocardiogram, ultrasound examination of internal organs, Doppler sonography of all key vessels, magnetic resonance imaging if necessary, and oral consultation with specialists are performed.

Delirium

It develops in several stages:

1. 
   In the afternoon (usually closer to night), signs of general excitement appear. Speech speeds up - often it becomes incoherent, meaningless and inconsistent, facial expressions become more animated, and excessive motor activity occurs. The patient sleeps very poorly and is bothered by realistic dreams. Tactile sensitivity sharply worsens - almost any touch makes you flinch. Characterized by mood swings and causeless anxiety.

2. Anxiety increases, and this feeling is accompanied by visual hallucinations, which in turn cause severe fear. Illusions are distinguished by their realism and bright emotional coloring. A person ceases to orient himself in time and space, but consciousness is partially preserved.
3. Symptoms reach their peak. Total insomnia is possible, hallucinations become more frequent and become even more realistic. Visual illusions are “joined” by auditory ones. But if visible images appear in close proximity, illusory sounds usually come as if from afar - from the street, from behind a wall, from ventilation shafts, etc. Physical activity is typical, which is quite dangerous - trying to escape from illusions, a person can jump out of a window or injure himself in another way. Symptoms worsen in the evening, visions become frightening.

There are several types of delirium:

• alcoholic, which occurs against the background of long-term binges, lasts up to 3-4 days, after which the alcoholic “falls” into deep sleep, then in most cases the symptoms disappear;
• exaggerated, most often manifests itself against the background of various encephalopathies. Symptoms are characterized by monotonous movements, repetition of the same words and sounds. Oral automatisms often occur and the temperature rises. Such an episode is forgotten;
• professional, which is characterized by repetitive movements associated with habitual activities (sewing, washing, ironing, printing, etc.). Usually accompanied by rapid heartbeat, hyperhidrosis, facial flushing, and fever.

What is disorientation?

It is classified as a mental disorder and can cause certain changes in the functioning of the central nervous system. It is divided into short-term and long-term, depending on a number of factors. The patient is unable to describe himself as a person; there is no temporal and spatial orientation. It should not be confused with childhood social disorientation, which is a temporary age-related process. The phenomenon is divided into two types: allopsychic, autopsychic. In the first case, there is an inability to determine location, as well as to separate time periods. In the second case, it is impossible to name the first name, last name, patronymic, date of birth, place of residence. For diagnosis, the right questions are asked and clarity is established. If it is confused, urgent consultation with a psychiatrist is necessary. To be admitted to a psychiatric hospital, the patient's voluntary consent to medical care is required. Impaired consciousness makes it impossible to objectively assess the situation; hospitalization is carried out according to the estimated condition at the time of treatment. Direct relatives and family members can help expedite legal issues.

For patients

In addition to innovative treatment methods, there are also digital support programs for patients with multiple sclerosis. For example, a mobile application that allows users to keep a diary of symptoms, nutrition and physical activity, and also allows them to monitor changes in well-being. These statistics can be shown to your doctor during your appointment.

By regularly filling out the diary, the user can keep the course of his illness under control. For convenience, the application will remind the patient to take the drug and to visit the attending physician.

There are contraindications, you should consult your doctor

Current of development

To correctly establish the primary diagnosis, it is necessary to note the causes of the anomaly. Fundamental experts identify the following factors:

• psychological disorders leading to a serious disorder in consciousness;
• stress, nervous overstrain;
• exceeding the norm of ppm alcohol in the blood;
• drug intoxication;
• medications: tranquilizers, antidepressants, sedatives;
• long-term exposure to increased background radiation;
• period of recovery from anesthesia;
• progressive depression;
• Alzheimer's disease;
• senile pseudosclerosis;
• vegetative-vascular dystonia;
• schizophrenia;
• hypoglycemia;
• senile dementia;
• lack of water resources in the body;
• insufficient kidney function;
• epileptic disease;
• malignant brain tumor;
• benign brain tumor;
• hyperthermia;
• infection with encephalitis tick.

Disorientation can be observed during a high-power impact and in a large emotional outburst. With this development, fainting often occurs. A one-time case is not a consequence of the occurrence of pathological processes. However, to be on the safe side, a consultation with a psychiatrist is necessary.

How are they treated today?

Due to the fact that doctors know a lot about the course of the disease, they can influence it at every stage, says Pavel Yakovlev.

These drugs certainly work, but only for the most common form of relapsing-remitting multiple sclerosis. Its course is characterized by clear exacerbations, after which the disease recedes for several months or even years. But, as a rule, after some time the disease moves to the next stage, when the person’s condition worsens. The drugs can reduce the frequency of exacerbations, minimize the harm they cause and delay the onset of the second stage. However, they do not work in progressive multiple sclerosis, when the patient's condition steadily worsens.

What is the life expectancy of people with multiple sclerosis? More details

Medical classification

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Disorientation is classified into radiation, occupational, spatial and social symptoms. Psychiatry identifies the term “autopsychic disorientation” - the lack of perception of personal factors (the inability to reproduce the last name, first name, patronymic, date of birth, that is, identification data). With this phenomenon, the individual’s surrounding world changes, and orientation in it is completely absent. A double perception of the world is noted, a real and imaginary environment is created, alternately visited by the psychological inner world. The full picture emerges after a proper examination by a doctor.

Twilight disorders of consciousness

They are characterized by an abrupt onset and spontaneous resolution. In this case, the connection with reality is lost with a total loss of orientation. This pattern lasts from several minutes to several hours. At the same time, logical (in accordance with the emerging illusions) behavior is noted. Subsequently, memory loss is typical.

In psychiatry, the following types of twilight disorders of consciousness are distinguished:

• Typical. The behavior practically does not change, but a detached or gloomy, angry expression appears. Sometimes speech disappears completely. At the same time, the patient is restless, wary, and short-term hallucinations are possible.
• Glucinatory. Often develop against the background of epilepsy. Bright, frightening hallucinatory images come to the fore, accompanied by a desire to defend themselves or, conversely, aggression towards others. Speech is either absent or turns into incoherent muttering.

• 
  Automatisms. They proceed without delirium, visions, violence. Certain actions are performed (for example, leaving for another city or even country), while from the outside the behavior seems completely normal. There is perhaps a somewhat detached look, but outsiders rarely pay attention to this. Subsequently, people do not remember anything from their actions and deeds.

• Fugues are a type of automatism, but they are very short-lived. Not understanding what is happening, the person starts to run, begins to undress, spins around, etc. Continues up to 2–3 minutes.

Symptoms of the disease

Changes that help establish the diagnosis are pronounced dizziness, variable mood, disturbed sleep, problems with remembering facts, inability to identify a person, internal psychological anxiety without outside provocation.

Spatial symptoms stand out: a sharp change in mood - an apathetic state changes to an aggressive one.

Help in this situation can only be found in a specialized institution that works with psychologically unbalanced people.

A separate category is social disorientation, which cannot be classified as a mental disorder. Its specific features: unclearly pronounced age, long-term adaptation to society, anxiety in an unusual situation.

Vegetative-vascular dystonia provokes worsening symptoms - vomiting, active progressive dizziness, tinnitus, complete or partial hearing loss, headaches, and fluctuating blood pressure.

The diagnostic complex involves an initial consultation with a psychiatrist and a neurologist. The doctor performs manipulations with the patient, a full physical examination with questions to help establish the correct diagnosis. From the point of view of physical manipulations, there is blood sampling for biochemistry and general clinical analysis. A test is performed to detect drugs in the body. Mandatory coagulogram and magnetic resonance imaging of the brain. At the same time, the patient is sent for specialized tests to identify his psychological level.

Pathogenesis

To successfully navigate in space, a person must maintain normal cognitive activity, recognize spatial landmarks, mentally imagine and remember space, and distinguish between left and right sides.

When the brain receives visual information, it processes it in the primary projection areas of the occipital cortex. Then it enters the posterior convexital sections, the lateral surface of the temporal lobe. This process allows you to recognize and determine the position of objects.

Short-term memory of space, thanks to which a person moves, is provided by the prefrontal cortex. Consequently, the basis for the pathogenesis of disorientation is the cognitive component, as well as the pathology of the activity of a number of brain structures.

Prevention

To prevent the development of diseases in which confusion and disorientation may develop, it is necessary to follow these rules:

• Eat right, trying to introduce the maximum amount of healthy and vitamin-rich foods into your diet.
• Lead an active life and play sports.
• Get rid of bad habits.
• Regularly train your memory and brain by solving crosswords, puzzles, etc.
• Get proper rest, sleep at least 7 hours a day.
• Conduct preventive blood tests, monitoring sugar levels, cholesterol and other indicators.
• Avoid head injuries.
• Timely and correct treatment of diseases of the nervous system, blood vessels, heart, etc.