Oneiroid syndrome is schizophrenic delirium, which is characterized by a specific kind of disturbance of the mind (dreamlike disorientation) with the presence of complete pictures of imaginary pseudo-hallucinatory and dreamy emotions, confused with evidence.
What manifestations does such a syndrome have?
Everything surrounding the patient is taken for deliberately rigged, where for him, "a play" with fake people (delirium double, dramatization). There is a loss in time and area, a pure orientation in the personal individual: the patient realizes that he is in the clinic, but at that moment he can be the captain of a spacecraft flying to other planets, and the people around him and medical workers are perceived as cosmonauts and messengers of other cultures greeting the ship. So the oneiric syndrome is manifested.
Symptoms caused by the behavior of a patient in this condition, contrasting with his fabulous pseudo-hallucinatory-delusional symptoms. As a rule, he lies calmly in bed, closing his eyes, sometimes makes “flight-measured” movements of his hands, looking at his wonderful incidents, but only from the outside. Along with this, the understanding of passing days and the age of the patient is being destroyed: he thinks that he has been in flight for many light years, and during this period he repeatedly passed away and was reborn by the method of cloning.
Signs of sleepwalking
Sometimes the patient does not rest, but wanders dreamily around the department with a "bewitched" smile, all striving in himself. When asked about something, he conveys some of his supernatural anxieties. Onyroid syndrome can manifest itself in the form of single catatonic signs, for example, sub-stage or catalepsy. It should be noted that the theme of emotions in the stage of a neuroid is taken from a personal skill, viewed films of a suitable plot or read books from a fairy tale series.
Upon exiting from such a state, the patient retains all wonderful feelings in his memory, however, he amnesises the real actions that happened in his life at the stage of such a pathological attack. Residual hallucinations may occur over several days.
The duration of the onyroid state can be 2-3 days or even 1-2 weeks. Often, this pathology occurs with schizophrenia, but sometimes it is found with internal brain damage and poisoning.
In what cases can such a disease be identified?
Onyroid syndrome occurs:
- with catatonic schizophrenia (often formed with characteristic dynamics);
- symptomatic psychoses (delirium tremens) ;
- epilepsy;
- with diseases of the brain.
Catatonic schizophrenia
At first, emotional disorders in the form of depressive and subdepressive moods are noted, then a period of delusional state appears, when the patient seems to be incomprehensible and changed around. Awkward feelings are accompanied by unsystematized stupid ideas, especially death, persecution, and malaise. Then comes the hallucination of mystery, intermetamorphosis and meaning.
Patients with onyroid syndrome indicate that a certain action is being performed near them, and they become either its spectators or participants. In this case, psychic automatisms, verbal delirium, false recognition are likely. Then the stage of sharp enchanting paraphrenia or directed oneiroid is formed, as a result of which the patient coexists fairy dreams, hallucinations and orientation in the actual situation. The clinical picture of catatonic schizophrenia ends with the development of a real onyroid.
Diagnostics
General measures for the diagnosis of schizophrenia are required. Special catatonic parameters can appear transistorically due to any form of such a disease. To make a diagnosis of this schizophrenia, one should determine a certain behavior of the patient in difficult conditions, if he has a oneiric syndrome:
- external causes);
- rigidity (maintaining a firm position in response to a test to change it);
- stupor (reduction of reactions to the environment, activity and spontaneous movements);
- hardening (voluntary reception and holding inappropriate, strange posture);
- waxy elasticity (holding parts of the body in their position);
- negativism (irrational obstruction or body movement in the opposite direction in response to efforts or attitudes to change posture, to budge);
- other symptoms (perseveration and automatic subordination).
Treatment of onyroid-catatonic syndrome in schizophrenia
It is possible to cope with malaise only in a psychiatric hospital with the help of medication, and sometimes with shock therapy. After the patient leaves the state of stupor, a long and often lifelong medication will be needed to prevent recurrence of catatonia. During an exacerbation, it will be necessary to bring the patient to a psychiatric clinic as soon as possible. As a rule, patients in such a situation often refuse to take food, can become confused because of a lack of orientation on the spot and in time, and also pose a huge threat to themselves and others.
Drug therapy
In order to cure catatonic schizophrenia, benzodiazepine tranquilizers are usually used, as well as GABA-based drugs. Sometimes muscle relaxants, dopamine antagonists and normotimics are added to the general treatment program. With a prolonged attack of catatonia, electroconvulsive therapy is successfully used.
Disease prognosis
You should be aware that the oneiric syndrome (the treatment of which was indicated above) is a very terrible condition both in somatic and mental terms. Such a patient should be put in a psychiatric hospital as soon as possible. This will prevent any risk associated with the life and health of the patient. In addition, such a group of people requires round-the-clock monitoring of the main vital functions, and it may also require intravenous infusion of drugs and parenteral nutrition.