Delirium - what is it? Science has its own definition - this is exogenous psychosis, which has a short-term nature. Most often, it lasts from several hours to several days. Origin may be:
- infectious
- intoxication;
- vascular;
- traumatic.
Etiology of delirium and its pathogenesis
Delirium (what it is, you can find out from the article) most often develops with:
- alcoholism (has the name "delirium tremens");
- drug addiction (drug delirium);
- severe infectious diseases (with critical changes in body temperature);
- intoxications (including drugs);
- senile dementia ;
- diseases of the cardiovascular system (hypertension, stroke, seizures);
- traumatic brain injuries or severe blood loss;
- previous operations (delirium is promoted by stress, insomnia, fever).
Patients who have already suffered a similar condition, under similar conditions, are prone to a recurrence of the situation.
Common symptoms of delirium
As a rule, the onset of this condition comes in acute form. However, if delirium occurs, some symptoms may signal its onset. They are called prodromal. These include:
- unjustified anxiety;
- anxiety;
- feeling of fear;
- increased sensitivity to light or sound;
- confused patient consciousness, disorientation.
When these symptoms occur, it can be said that a state of delirium has occurred. A person in this state can confuse dreams and reality due to a violation of the cyclical nature of the sleep and wakefulness periods. Also, patients are indistinguishable from dreams and true hallucinations. Attention is reduced, irrelevant stimuli can switch it quite easily. In addition, other thought processes slow down significantly. A person may not remember what happened to him during the delirium, or perceive it as a dream due to the memorization of only certain pieces.
Diagnosis of the disease
There are certain criteria that help diagnose delirium:
- Involuntary attention, the patient is not able to concentrate on a specific subject. For example, such a person needs to repeat the question many times in order to hear the answer to it.
- A disorganization of thinking, which manifests itself in the fact that a patient with delirium jumps from one subject to another or speaks statements that are incomprehensible to the environment.
- Decreased level of consciousness (difficulty maintaining daytime wakefulness), perceptual disturbances (impossibility of awareness, an illusion or hallucinations, colorful dreams that are perceived by the patient as reality), impaired sleep and wakefulness, increased psychomotor activity, or, conversely, its decrease memory impairment. These criteria may not be present at the same time, but only one of them.
- The development of delirium in the shortest possible time. Usually this does not exceed several days.
- Disorientation over time.
Features of the diagnosis of the disease
Delirium is characterized by the rapid and sudden onset of symptoms, which makes it possible to diagnose the disease at home. Typical are changes in the severity of a particular symptom throughout the day. Accurate knowledge about the presence of any head injuries or a certain physical or infectious disease, as well as alcoholism or drug addiction will help facilitate the diagnosis.
Delirium (what it is, described earlier) refers to diseases that can be treated. If you discover the cause that caused it in time, then the treatment can give positive results. In some situations, the disease goes away on its own, but do not let the situation go by its own accord, since complications are also possible.
Rules for treating delirium
If the diagnosis is "delirium", treatment should be carried out without fail by a doctor. The main principle of treatment is determining the cause of the occurrence. After that, the collection of tests and their outpatient research is carried out. Based on the results, the doctor prescribes medication or surgery.
In addition to eliminating the cause of delirium, for example, the treatment of alcoholism, measures are being taken to facilitate the course of the disease, as well as the prevention of possible complications. For this, patients are supported by a certain nutrition, as well as the balance of electrolytes of liquids.
In addition to the cause of delirium, the choice of treatment is influenced by the environment in which the symptoms appeared, the patient's age and his neurological status. During the recovery process, it is very important to provide the patient with comfortable living conditions.
For example, treatment of alcohol delirium occurs according to the following scheme:
- taking "Sibazon" and "Sodium oxybutyrate";
- normalization of electrolyte balance;
- normalizing breathing and lung function (using the drug Mannitol);
- restoration of the liver and kidneys;
- reduction or elimination of hyperthermia;
- treatment of concomitant diseases.
For patients who are afraid or aggressive, sedatives are prescribed (which ones and their dosage is determined by the attending physician).
Alcoholic delirium and its characteristics
With alcoholism, along with other terrible conditions of the patient, alcohol delirium can be observed, or, in other words, delirium tremens.
Alcohol delirium (symptoms similar to conditions of a different origin) - this is acute psychosis under the influence of alcohol. Such a state is characterized by sudden disorders of consciousness, terrible hallucinations, disorientation in space and time, delirium, inexplicable fear and aggression, as well as intense excitement.
This condition, as a rule, occurs two days after the patient ceases binge. In some cases, it is observed during the drunken period itself. The first attack of delirium tremens can occur after a sufficiently long period of binge. All subsequent attacks do not require prolonged binge.
How to recognize delirium tremens?
Delirium syndrome is easy to recognize, since there are certain signs:
- The patient stops drinking alcohol after binge due to the fact that he disliked.
- In the evening, a change of mood occurs, and quite suddenly. During this period, the patient may be too excited and anxious, chatting incessantly, does not find a place for himself.
- Trembling limbs.
- Having trouble sleeping. He becomes restless and short-lived, often the patient sees nightmares. After that, absolute insomnia may occur, which helps to increase feelings of fear, anxiety and anxiety.
- Hallucinations appear, both auditory and visual. The patient may begin to hear various voices that supposedly intimidate him. The visual images that arise are quite frightening. Every day the scale of these hallucinations is increasing.
This condition in a person suffering from alcoholism can last up to several days.
Symptoms of Alcohol Delirium
The main symptoms of delirium alcoholic origin are:
- Visual hallucinations. Most often, the attack begins in the evening and progresses quickly enough. A person begins to see visual imaginary images, taking shadows from things for monsters. Hallucinations depend on the patient's fears. In some situations, these hallucinations are not perceived by a person as reality, but rather resemble watching a movie.
- Auditory hallucinations. They arise not separately, but, as a rule, in combination with the visual, and are completely related to them. The patient may hear various rustles, screams, fictitious requests for help or warnings. It seems to him that something very bad is going on around, wants to help, but he is mortally afraid of doing it. Sometimes he can conduct a dialogue with imaginary interlocutors.
- Tactile hallucinations. The movements and facial expressions of a person with alcoholic delirium are fully consistent with those visions that haunt him. The patient begins to build on those monsters that he sees, brush them off, hide, and hide in a corner. In addition, such a person clearly feels himself being bitten, beaten, or otherwise hurt. At such moments, he poses 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 get away from those voices that the patient hears within himself.
- Disorientation in time and space. The delirium state is characterized by erroneous orientation both in space and in time. The patient may not know where exactly he is, does not recognize his relatives, the time orientation is also impaired. However, you can name the surname, name or other data without any difficulties.
As a rule, if the patient has true delirium, the symptoms intensify in the evening. In the afternoon, the condition may slightly improve, however, you should not refuse treatment.
There are periods when the patient's manifestations of delirium almost completely disappear. This condition is called the lucid gap. At this time, the patient can easily talk about all the hallucinations that he had.
Possible consequences
If delirium is not treated (what it is, 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 rate;
- dehydration of the body;
- increase in acidity;
- difficulty in movement;
- tremor;
- chills with alternating sweating, sometimes the smell of unwashed legs;
- enlarged liver;
- pallor of the skin or, conversely, its redness.
If you do not start treatment for delirium in time, these changes cannot be avoided. With the manifestation of these complications, we can talk about the irreversibility of the process.
Often, the cause of death of alcoholic delirium is 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 alcoholic delirium), acute renal failure, edema brain rhabdomyolysis (skeletal muscle necrosis).
Delirium Prevention
In order to protect themselves from the possible manifestation of delirium of various origins, prevention is necessary. 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 to avoid possible complications;
- informed use of drugs, refusal of self-medication, in particular antidepressants, sleeping pills, tranquilizers;
- careful patient care in the postoperative period, especially for the elderly.
What doctors can help?
If you suspect that your family or friends have developed delirium, consult a neurologist or narcologist. Then avoid unwanted consequences will surely succeed.