Delirium - what is it? Science has its own definition - it is an exogenous psychosis of short duration. Most often lasts from several hours to several days. The origin may be:
- infectious;
- intoxication;
- vascular;
- traumatic.
The etiology of delirium and its pathogenesis
Delirium (what it is, you can learn from the article) often develops when:
- alcoholism (has the name "delirium tremens");
- drug addiction (delirium tremens);
- infectious diseases of severe severity (with critical changes in body temperature);
- intoxication (and medicinal including);
- senile dementia;
- diseases of the cardiovascular system (hypertension, stroke, seizures);
- traumatic brain injury or severe blood loss;
- transferred operations (delirium is promoted by stress, insomnia, fever).
Patients who have already endured such a condition, under similar conditions tend to repeat the situation.
Common symptoms of delirium
As a rule, the beginning of such a state comes in acute form. However, if delirium occurs, some symptoms may signal its onset. They are called prodromal. These include:
- undue anxiety;
- anxiety;
- feeling of fear;
- increased sensitivity to light or sound;
- confused consciousness of the patient, disorientation.
If these symptoms occur, you can talkthat came the state of delirium. A person in this state may confuse dreams and reality due to the violation of the cyclical nature of the period of sleep and wakefulness. Also, dreams and true hallucinations are indistinguishable to patients. Attention decreases, irrelevant incentives can switch it fairly easily. In addition, other thought processes slow down significantly. A person may not remember what happened to him during the period of delirium, or he could perceive it as a dream because of memorizing only individual pieces.
Diagnosis of the disease
There are certain criteria that help diagnose delirium:
- The involuntary attention, the patient is not able to concentrate on a particular subject. For example, such a person needs to repeat a question many times to hear the answer.
- Disorganization of thinking, which is expressed in the fact that a patient with delirium jumps from one object to another or speaks incomprehensible to the surrounding statements.
- Decreased level of consciousness (difficulty inmaintaining a state of wakefulness during the daytime), perceptual disturbances (impossibility of awareness, illusion or hallucinations, colorful dreams perceived by the patient as reality), disturbance of the cyclical nature of sleep and wakefulness, increased psychomotor activity or, on the contrary, its decline, impaired memory. These criteria may not be present at the same time, but only one of them.
- The development of the state of delirium in the shortest possible time. Usually it does not exceed several days.
- Disorientation in time.
Features of the diagnosis of the disease
Delirium is characterized by a quick and sudden appearance.symptoms that allows you to diagnose the disease at home. Typical are changes in the severity of a particular symptom during the day. To facilitate the diagnosis will help accurate knowledge of the presence of any head injuries or a specific physical or infectious disease, as well as alcoholism or drug addiction.
Delirium (what is it described earlier) refersto treatable diseases. If in time to find the cause that caused it, the treatment being conducted can give positive results. In some situations, the disease passes on its own, but you should not let the situation take its course, since complications are also possible.
Rules for treating delirium
If delirium is diagnosed, treatment shouldmandatory conduct a doctor. The main principle of treatment is to determine the cause. After that, the collection of analyzes and their outpatient study. Based on the results obtained, the doctor prescribes a drug or surgical treatment.
In addition to eliminating the cause of delirium, for exampletreatment of alcoholism, measures are being taken that are aimed at alleviating the course of the disease, as well as preventing possible complications. To do this, patients are supported by a certain nutrition, as well as the balance of electrolytes in liquids.
In addition to the cause of delirium, the choiceThe treatment is affected by the environment in which the symptoms appeared, the patient's age and his neurological status. During the healing process it is very important to provide the patient with comfortable living conditions.
For example, the treatment of delirium tremens occurs as follows:
- taking Sibazon and sodium oxybutyrate;
- balancing electrolyte balance;
- normalizing respiration and lung function (using the drug Mannit);
- restoration of the liver and kidneys;
- reduction or elimination of hyperthermia;
- treatment of associated diseases.
For patients who are scared or aggressive, sedatives are prescribed (which ones and their dosage is determined by the attending physician).
Delirium and its characteristics
In alcoholism, along with other terrible conditions of the patient, delirium tremens may be observed, or, in other words, delirium tremens.
Delirium tremens (symptoms similar to those ofother origin) is an acute psychosis under the influence of alcohol. Sudden disorders of consciousness, terrible hallucinations, disorientation in space and time, delirium, inexplicable fear and aggression, as well as strong arousal are inherent in this state.
This condition usually occurs throughtwo days after the patient stops drinking. In some cases, there is also a drunken period itself. The first attack of delirium tremens may occur after a sufficiently long period of hard drinking. All subsequent attacks do not require a long binge.
How to recognize the delirium tremens?
Delirium syndrome is easy to recognize, as there are certain signs:
- The patient stops drinking alcohol after a binge due to the fact that he is rebellious.
- In the evening, there is a change of mood, and quite suddenly. During this period, the patient may be too excited and restless, talk incessantly, does not find a place for himself.
- The trembling of the limbs intensifies.
- Возникают проблемы со сном.He becomes restless and short-lived, often the patient sees nightmares. After that, absolute insomnia may occur, which contributes to increased feelings of fear, anxiety and anxiety.
- There are hallucinations of both auditory andvisual. The patient may begin to hear different voices that supposedly intimidate him. The visual images that arise are quite frightening. Every day the scale of these hallucinations increase.
This condition in a person suffering from alcoholism, can last up to several days.
Symptoms of alcohol delirium
The main symptoms of delirium alcohol are:
- Visual hallucinations.Most often the attack begins in the evening and progresses fairly quickly. A man begins to see visual imaginary images, taking the shadows of things for monsters. Hallucinations depend on the patient's fears. In some situations, these hallucinations are not perceived by man as a reality, but rather resemble watching a movie.
- Auditory hallucinations.They do not arise in isolation, but, as a rule, in combination with visual ones, and are completely connected with them by the subject. The patient may hear various rustles, shouts, fictitious requests for help or caution. It seems to him that something very bad is happening around him, he wants to help, but he is mortally afraid to do it. Sometimes he can carry on a dialogue with imaginary interlocutors.
- Tactile hallucinations.The movements and facial expressions of a person with delirium tremens are fully consistent with the visions that follow him. The patient begins to make a start from those monsters he sees, brush them off, hide, get into the corner. In addition, such a person clearly feels like being bitten, beaten or otherwise hurt. At such moments, he represents a great danger to others, because he can grab a thing and supposedly start saving someone. Another negative result may be suicide, which is an attempt to escape from the voices that the patient hears inside.
- Disorientation in time and space.The state of delirium is characterized by an erroneous orientation both in space and in time. The patient may not know exactly where he is, do not recognize his relatives, his orientation in time is also broken. However, it is not difficult to give a name, surname or other information.
As a rule, if the patient has true delirium, the symptoms are worse in the evening. During the day, the condition may slightly improve, but it is still not worth refusing treatment.
There are periods when the patient is practicallymanifestations of delirium completely disappear. This condition is called the luceoid gap. At this time, the patient can easily tell about all the hallucinations that he had.
Possible consequences
If you do not treat delirium (what it is, as indicated at the beginning of the article), it can lead to complications, in particular to physiological changes:
- temperature increase, in some cases up to 40 degrees;
- increased pressure, irregular heart rhythm;
- dehydration;
- increase in acidity;
- difficulty of movement;
- tremor;
- chill with alternating sweating, sometimes the smell of unwashed feet;
- enlarged liver;
- pallor of the skin or, conversely, its redness.
If you do not start treating delirium on time, these changes cannot be avoided. With the manifestation of these complications, we can talk about the irreversibility of the process.
Very often the cause of deathdelirium tremens are associated diseases such as pneumonia (accompanies severe delirium in 30% of cases), cardiomyopathy (heart failure), acute pancreatitis (one of the most common concomitant diseases of delirium tremens), acute renal failure, cerebral edema, rhabdomyolysis ( skeletal muscle necrosis).
Prevention of delirium
In order to protect yourself from the possible manifestation of delirium of different origin, you need to carry out prevention. It includes the following activities:
- maintaining a healthy lifestyle, in particular the treatment of alcoholism and drug addiction;
- timely and correct treatment of various neurological and somatic diseases in order to avoid possible complications;
- conscious medication, refusal of self-medication, in particular antidepressants, sleeping pills, tranquilizers;
- careful care of patients in the postoperative period, especially for the elderly.
What doctors can help?
If you suspect the development of delirium in your relatives or friends, contact a neurologist or a narcologist. Then avoid undesirable consequences necessarily succeed.
