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Consciousness Syndromes

A working clinical definition of consciousness as a mental process that allows you to navigate in the world (news and time) and in your own personality, lead G.K. Kaplan and B.J. Sedok (1994).

The classic of German psychiatry and the famous existentialist philosopher Karl Jaspers (1883-1969) as early as 1911. summarized the main signs (criteria) of impaired consciousness inherent in all types of disorders of consciousness:

1. There is a detachment from the outside world. The outside world is not perceived or perceived fragmentary.

2. The orientation in time, place, self is violated.

3. There is incoherent thinking.

4. Retrograde amnesia of the period of impaired consciousness.

Syndromes of impaired consciousness are divided into 2 large groups:

1. Syndromes of turned off consciousness are characterized by a complete loss of reflective activity of the brain and mental functions. Consciousness is turned off completely. Turning off consciousness occurs, for example, with a head injury (brain injury), with epileptic seizures.

There are three degrees of depth of consciousness disorder:

Stupor (stunning), in which the perception and processing of impressions is much more difficult, orientation is incomplete or absent.

Sopor - a deeper degree, when mental functions disappear completely, tactile, painful sensitivity remains.

Coma is the deepest degree, with it only vital functions are preserved, which are regulated at the level of unconditioned reflexes (cardiac, respiratory activity). With a deepening coma, changes in their work and the death of the patient.

2. Syndromes of dull consciousness are somewhat similar to the phase of REM sleep, when consciousness is impaired, but the psyche works at the level of images, and these images are extrapolated, as it were, go out in the form of visual hallucinations.

Delirium - confusion with the presence of true visual hallucinations. During delirium, the orientation in the environment is always disturbed while the orientation in the self is intact. One person, escaping from monsters, crawls under the bed, another takes an ax and can kill a man whom he took for a bandit, a third jumps out the window. Delirium does not last long (up to 3 days). Abortive delirium lasts several hours. If delirium lasts more than 3 days, then the patient must look for a concomitant intercurrent disease that interferes with the exit from delirium. The exit from delirium is always critical (fast). The delirious patient falls asleep (himself or with the help of doctors) and wakes up already without psychosis.

Oneyroid. Onyroid (dream) clouding of consciousness. Oneyros is the god of sleep. Dreamy, dreamlike clouding of consciousness. The patient seems to have a waking dream.
The experiences of patients are fantastic, unusual. Disorientation in space and time is characteristic. The influx of panoramic visual hallucinations. Everything around is changing, the person himself is changing, there can be transformations.

Amentia (acute nonsense). Confusion with a predominance of incoherent speech-motor agitation against the background of confusion.

Twilight clouding of consciousness. It develops and stops suddenly, has a clear beginning and end, is characterized by a rough disorientation in place and time. In general, the patient’s behavior in the twilight state of consciousness is subject to delusional experiences, hallucinations, the affect of fear, anger, and longing. Often is a psychomotor agitation of an impulsive nature with aggressive destructive actions.

Three variants of twilight consciousness disorder are distinguished.

- oriented twilight state, in which disorientation is fragmentary and the possibility of recognizing individual places and people remains. However, unmotivated anger, irritation, accompanied by severe aggression, become the leading behavior.

- a paranoid (delusional) option, in which a change in consciousness is accompanied by acute figurative delirium with the content of persecution, danger. The behavior of such patients is characterized by delusional excitement with aggression due to painful experiences.

- chaotic violent excitement caused by the influx of hallucinations and illusions. Behavior is extremely dangerous and destructive.

After leaving the twilight disorder of consciousness, memories of the painful period, as a rule, are absent. Twilight disorders of consciousness are extremely dangerous conditions. Patients with such a mental disorder often commit serious, dangerous actions against their loved ones, those around them, completely unfamiliar people. Cases are described when patients with epilepsy in the twilight state of consciousness killed their beloved children, wives, close relatives.

Short-term states of turning off consciousness with convulsive or other involuntary movements occur with epilepsy. The patient is completely disoriented in the place, time, self, is as if at dusk. The patient still has the possibility of automated actions. Often, patients commit aggressive actions. After the twilight disorder is over, they do not relate these actions to themselves.

Fugue, trance - variants of twilight stupor of consciousness, manifested by involuntary wandering in a state of altered consciousness. Outwardly sick people give the impression of people immersed in their thoughts.

Somnambulism (sleepwalking, sleepwalking) - ambulatory automatism that occurs during sleep.
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Consciousness Syndromes

  1. INTENSIVE THERAPY OF PAIN SYNDROME AND DISORDERS OF CONSCIOUSNESS
    INTENSIVE THERAPY OF PAIN SYNDROME AND DISORDERS
  2. INTENSIVE THERAPY OF PAIN SYNDROME AND DISORDERS OF CONSCIOUSNESS
    INTENSIVE THERAPY OF PAIN SYNDROME AND DISORDERS
  3. Impaired consciousness
    Impairment of consciousness is an extremely common problem in the intensive care unit (ICU), but when faced with it, doctors usually experience difficulties due to the lack of an accurate definition of coma. However, even moderate changes in consciousness are associated with high mortality, if they are not the result of the deliberate administration of sedatives. Although the frequency of conditions accompanied by
  4. Acute impaired consciousness
    Consciousness is the highest form of reflection of reality, which is a combination of mental processes that allow a person to navigate in the world, time, self, which ensures his behavior. Impairment of consciousness is the general name for disorders of the integral activity of the brain, expressed in impaired ability to perceive adequately,
  5. BASIC NEUROLOGICAL SYNDROMES MOTOR VIOLATIONS SYNDROMES
    the brain the pyramidal path, motor cells of the spinal cord, anterior root, peripheral nerve) the impulse becomes impossible, and the corresponding muscles can no longer participate in the movement - it is paralyzed. Thus, paralysis, or plegia, is the lack of movement in a muscle or muscle group as a result of a break in motor reflex
  6. COMA AND OTHER DISORDERS OF CONSCIOUSNESS
    Allen G. Ropper, Joseph B. Martin (Alien H. Ropper, Joseph W. Martin) Coma is one of the most common impaired consciousness. It has been established that about 3% of visits to intensive care units of city hospitals are conditions accompanied by loss of consciousness. The importance of this class of neurological disorders determines the need for a systematic approach to their diagnosis and
  7. Speech Disorders Syndromes
    Speech disorders in children with cerebral palsy are characterized by delayed speech development, dysarthria and alalia. The delay in speech development is noted already in the pre-speech period. Humming and babbling appear late, differ in fragmentation, poverty of sound complexes, low voice activity. The first words are also late, the active dictionary accumulates slowly, the formation
  8. Speech Disorder Syndromes
    Speech disorders in children with cerebral palsy are characterized by delayed speech development, dysarthria and alalia. The delay in speech development is noted already in the pre-speech period. Humming and babbling appear late, differ in fragmentation, poverty of sound complexes, low voice activity. The first words are also late, the active dictionary accumulates slowly, the formation
  9. Speech Disorder Syndromes
    Speech disorders in children with cerebral palsy are characterized by delayed speech development, dysarthria and alalia. The delay in speech development is noted already in the pre-speech period. Humming and babbling appear late, differ in fragmentation, poverty of sound complexes, low voice activity. The first words are also late, the active dictionary accumulates slowly, the formation
  10. Hearing Disorders
    Hearing impairment is indicated by the term “hypacusia”; hearing loss i.e. deafness, denoted by the term “cashew,” or “surditas.” Unilateral damage to the auditory zone of the cerebral cortex, the pathways from the nuclei of the auditory nerve and the optic tubercle does not lead to hearing impairment, since impulses from the nuclei of the auditory nerve come into the cerebral cortex of their own and opposite sides. In that
  11. SYNDROMES OF MOTOR VIOLATIONS
    Motor disorders in cerebral palsy due to the fact that increased muscle tone, combined with pathological tonic reflexes (tonic labyrinth and cervical reflexes), interferes with the normal development of age-related motor skills. Tonic reflexes are normal reflexes in children under the age of 2 to 3 months. However, with cerebral palsy their
  12. Visual Impairment Syndromes
    Visual Impairment A decrease in visual acuity is called amblyopia; lack of vision - amaurosis. In adults and older children, visual acuity is 1.0. Such visual acuity is established only after 5 years. In the first half of life, it is 0.02 - 0.04, by 1 year it reaches 0.1. With a sharp decrease in vision, when the patient does not distinguish letters or pictures on the table, his
  13. Syndromes of Violations of Higher Cortical Functions
    Violations of spatial representations. The perception of space (spatial gnosis) is considered as the result of the joint activity of various analyzers, among which the motor-kinesthetic is of particular importance. In children with cerebral palsy, there is an underdevelopment of spatial gnosis, which is associated with underdevelopment or damage to the parietal lobe of large
  14. SYNDROMES REFLECTING TYPICAL PROTEIN VIOLATIONS
    Syndromes: • shift in nitrogen balance; • hyperaminoacidemia; • aminoaciduria; • hyperazotemia; • dysproteinemia; • dysproteinoses. The most common causes of nitrogen imbalance were mentioned in the description of the violation of the stage of protein intake in the body. Hyperaminoacidemia was considered by us in the section devoted to interstitial metabolic disorders. Again
  15. SENSITIVITY SYNDROMES AND SENSITIVITY FUNCTIONS
    Three main types of sensitivity disorders are distinguished depending on the distribution borders: peripheral - in the area of ​​nerve innervation, segmental - in the area of ​​innervation of the segment of the spinal cord, posterior (sensitive) root or intervertebral ganglion, conductor - below the level of damage to the conductors of sensitivity in the spinal cord or brain. Depending on the level of lesions
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