Oneiric Syndrome is a schizophrenic delirium characterized by a specific type of mind disturbance (dream-like disorientation) with full pictures of imaginary pseudo-hallucinatory and dream emotions confusing with the obvious.
What are the manifestations of this syndrome?
Everything around is taken by the patient as deliberately rigged, where a performance is “played out” for him with dummy people (delusions of a double, staging). There is a loss in time and place, a special orientation in a personal individual: the patient realizes that he is in the clinic, but at that moment he can be the captain of a spaceship flying to other planets, and the people around him and medical workers are perceived as astronauts and envoys of other cultures welcoming the ship. This is how the oneiroid syndrome manifests itself.
Symptoms are caused by the behavior of the patient in this state, contrasting with his fabulouspseudo-hallucinatory-delusional symptoms. As a rule, he lies calmly in bed, closing his eyes, sometimes making “flying-measured” movements with his hands, looking at his miraculous events, but only from the side. Along with this, the understanding of the passing days and the age of the patient is destroyed: he thinks that he has been in flight for many light years, and during this period he repeatedly passed away and was revived by cloning.
Signs of sleepwalking
Sometimes the patient does not rest, but dreamily wanders around the department with a "bewitched" smile, all aspiring to himself. When asked about something, he conveys some of his uncanny anxieties. Oneiroid syndrome can manifest itself in the form of single catatonic signs, for example, substupor or catalepsy. It should be noted that the theme of emotions in the oneiroid stage is taken from a personal skill, watched films of a suitable plot or read books from a fairy tale series.
When leaving such a state, the patient saves in his memory all the wonderful feelings, but amnesiazes the real actions that happened in his life at the stage of such a pathological attack. Residual hallucinations may occur for several days.
The duration of the oneiroid state can be 2-3 days or even 1-2 weeks. Often this pathology occurs in schizophrenia, but sometimes it is found in internal brain damage and poisoning.
In what cases can such aillness?
Oneiroid syndrome occurs:
- with catatonic schizophrenia (often formed with characteristic dynamics);
- symptomatic psychosis (delirium tremens);
- epilepsy;
- in diseases of the brain.
Catonic schizophrenia
At first, emotional disorders are noted in the form of depressive and subdepressive moods, then a period of delusional state appears, when the surrounding seems to the patient incomprehensible and changed. Clumsy feelings are accompanied by unsystematized stupid ideas, especially death, persecution, ailments. Then comes the hallucination of mystery, intermetamorphosis and meaning.
Patients with oneiroid syndrome indicate that a certain action is taking place near them, and they become either its spectators or participants. At the same time, mental automatisms, verbal delirium, false recognitions are likely. Then a stage of sharp enchanting paraphrenia or a directed oneiroid is formed, as a result of which fairy-tale dreams, hallucinations and orientation in the actual situation coexist in the patient. The clinical picture of catatonic schizophrenia ends with the development of a true oneiroid.
Diagnosis
General measures of schizophrenia diagnosis are required. Special catatonic indicators can appear transistorized due to any form of such a disease. To make a diagnosis of this schizophrenia, it is necessary to determine some character of the patient's behavior insevere conditions if he has oneiroid syndrome:
- external causes);
- rigidity (maintaining a firm position in response to an attempt to change it);
- stupor (reduction of reactions to the environment, activity and spontaneous movements);
- freezing (voluntarily accepting and holding an inappropriate, strange posture);
- wax elasticity (holding body parts in a given position);
- negativism (irrational obstruction or body movement in the opposite direction in response to efforts or attitudes to change posture, move from place);
- other symptoms (perseveration and automatic submission).
Treatment of oneiroid-catatonic syndrome in schizophrenia
To cope with the malaise is really only in a psychiatric hospital with the help of drug, and sometimes shock therapy. Once the patient is out of the stupor, a long and often lifelong drug treatment is needed to prevent recurrences 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 due to a lack of orientation in place and time, and also pose a huge threat to themselves and others.
Drug therapy
To treat catatonic schizophrenia, benzodiazepine tranquilizers are commonly used, as well asmedicines based on GABA. Sometimes muscle relaxants, dopamine antagonists and mood stabilizers are added to the general treatment program. With a prolonged attack of catatonia, electroconvulsive therapy is successfully used.
Disease prognosis
It should be realized that oneiroid syndrome (the treatment of which was indicated above) is a very terrible condition both in somatic and mental terms. Such a patient should be admitted to a psychiatric hospital as soon as possible. This will prevent any risk associated with the life and he alth of the patient. In addition, this group of people require 24/7 monitoring of major vital signs and may also require intravenous medications and parenteral nutrition.
