Usual clinical stupor manifests itself in a depressed psychological state of the patient, weak pupillary response to light and dulling of pain sensations.
A soporous state can transform into a coma, which is an extreme degree of inhibition of all body functions. There is a complete shutdown at the reflex level. To prevent this condition, you should know what provokes the appearance of stupor.
What is the difference between stupor and coma
The main difference between sopor and coma lies in the fact that the first state is a lack of contact with the outside world, accompanied by loss of consciousness. But a person can be taken out of it at least for a short time. This can be achieved by vigorous shaking, tingling, loud voice. Coma, on the other hand, is an unconscious state that can be compared to a very deep sleep or anesthesia, from which it is impossible to wake up. A person in a coma does not even respond to pain.
Cause of stupor
To the most common reasons causingstupor, can be attributed to:
- complications caused by cerebral hemorrhage;
- presence of benign or malignant neoplasms in the brain;
- chronic diseases;
- toxic damage to the body;
- viruses and infections;
- thrombophlebitis;
- atherosclerosis;
- drug overdose, especially tranquilizers;
- wrong lifestyle;
- violation of metabolic processes in the body;
- hypertensive crisis in severe form;
- head injury;
- expressed deviations of glucose in diabetes mellitus;
- low thyroid function (hypothyroidism);
- violation of metabolic processes in nephritis;
- ruptured aneurysm;
- poisoning the body with carbon monoxide, barbiturates, opioids;
- meningitis;
- meningoencephalitis;
- cardiac ischemia;
- blood poisoning (sepsis);
- electrolyte imbalance in the body;
- heat stroke.
Symptoms of disease
If a he althy central nervous system constantly reacts to changing environmental conditions, then in a state of stupor, brain activity is in a state of inhibition. The body seems to be in a long sleep. The soporous state can transform into a coma.
The brain cannot make any decisions. Wakefulness and sleep can change abruptly.
Many are interested in: "How long does the constipation last?". Shutdown periodscan last from a few seconds to months. It all depends on the reason that caused the process.
When stupor, the patient may feel some cloudiness, confusion in understanding everything that is happening around. He may show disorientation in space. The patient may confuse dates and names, not remember the events that happened yesterday, but at the same time, distinct pictures of the distant past emerge in his memory.
Strong irritants can cause a reaction in a person. A sharp sound causes the eyelids to open, but purposefully the patient is not looking for anything. Impact on the nail bed provokes twitching of the limb. An injection, a pat on the cheek can cause a short-term negative reaction in the patient.
On examination, there is a decrease in muscle tone and depression of deep reflexes. Often found pyramidal syndrome caused by the suppression of the central neurons. The reaction of the pupils to light is sluggish, the corneal and swallowing reflex is preserved.
In parallel with all these symptoms, neurological signs of a focal nature may appear, indicating a local lesion of certain areas in the cerebral cortex.
If the soporous condition is provoked by a stroke or meningoencephalitis, neck stiffness and other meningeal symptoms will be detected. Uncontrollable muscle twitches may also occur.
In some cases, doctors are faced with a hyperkinetic variant of stupor, in which a person is incoherentlyspeaks, looks around, makes purposeful movements. Establishing a productive contact with the patient is impossible. This condition is similar to delirium, which belongs to the category of qualitative disorders of consciousness.
The constipation after a stroke can be characterized by a high degree of agitation or complete indifference to everything around.
Stupor in stroke
Stroke is a very dangerous disease that causes unpredictable complications. Sopor is one of them. Translated from Latin, the word "sopor" means "sleep", "numbness", "lethargy", "loss of memory". In medicine, this condition is usually called a subcoma, since it is a step towards the development of a coma and is in many ways similar to this serious condition.
Soporous state in stroke is expressed in the dulling of all human reactions. The activity of consciousness is in an extremely depressed state.
Stroke is caused by pathological processes in the vessels that provoke acute brain dysfunction. The duration of the consequences of apoplexy is more than a day. Stroke can lead to rapid death.
Sopor not always, but quite often accompanies a stroke. It is noted in about one fifth of cases of all cerebral necrosis. The manifestation of this condition can be observed not only in the acute period of the disease, but also during its rehabilitation. The process is directly dependent on the area and degree of brain damage.
Ignore this complicationit is impossible under any circumstances, since most often it quickly turns into a coma.
Clinical picture of stupor in stroke
Soporous state in stroke, the prognosis of which depends on the degree of prevalence of cerebral necrosis, manifests itself in drowsiness and lethargy of the patient. In parallel with this, protective reactions to stimuli such as pain, sharp sound and light are preserved. The patient does not respond to his environment, cannot answer questions, is unable to perform any task. Muscle tension in the limbs is reduced, tendon reflexes are dulled, and coordination of movements is lost.
Epileptic stupor
A stopper always accompanies an epileptic seizure. Epilepsy in medicine is called a state of increased convulsive readiness. In such patients, the appearance of seizures is provoked by a certain situation, to which he althy people do not react in this way. Many researchers believe that the disease is hereditary.
Usually, an epileptic seizure is preceded by a sharp change in the emotional background of the patient. 2-3 days before the seizure, the person becomes agitated, tense and anxious. Some patients withdraw into themselves, others show aggression towards others. Shortly before the attack, there is an aura that is difficult to describe in words. It is characterized by a variety of tactile sensations: taste in the mouth, vague sounds and smells. We can say that the aura marks the epilepticfit.
In the human cerebral cortex there is a focus of excitation. It covers more and more nerve cells. The end result is a seizure. Typically, the duration of the phase is 30 seconds, rarely one minute. The patient's muscles are in great tension. The head is tilted back. The patient screams, breathing stops.
The convulsive stage lasts up to 5 minutes. With it, all the muscles of the patient involuntarily contract. After the seizure ends, the muscles relax again. The patient's consciousness is turned off. Soporous state in epilepsy lasts 15-30 minutes. After leaving the stupor, the patient falls into a deep sleep.
Stupor due to dehydration
Such a complication as stupor can also accompany dehydration. In medicine, water deficiency is commonly called exsicosis. In this condition, there is a low content of electrolytes and water, which is provoked by repeated persistent vomiting and severe indigestion.
In addition, fluid loss can be caused by pathological processes in the kidneys and lungs. Exsicosis usually develops gradually within 2-3 days from the onset of the provocative disease.
Dehydration is characterized by the patient's lethargy, loss of appetite, refusal to drink. Fluid intake causes profuse vomiting. There is a decrease in muscle tone, the patient's body temperature, as well as pressure, drops sharply. There is oliguria or anuria.
Soporous condition from dehydration can turn intoto whom.
Prognosis for constipation
What is the outcome of the course of the disease? A soporous condition, the prognosis of which depends on the provoking cause, should be treated in a timely manner. An important role is played by the degree of damage to the nervous tissue and the amount of therapy.
The earlier the measures were taken to correct the disorder, the higher the patient's chance of regaining a clear consciousness and regression of the symptoms of the underlying disease.
Diagnosis
Stupor caused by a stroke can be fatal. At the first mild manifestations of a complication, it is necessary to conduct a timely diagnosis.
Priority measures include:
- blood pressure measurement;
- Checking heart rate and breathing;
- Checking the reaction of pupils to light and determining the degree of their mobility;
- measurement of body temperature, with its high rate, one can judge the presence of an infection in the patient's blood;
- examination of the skin for injuries, vascular lesions or allergic manifestations.
Necessary examinations
The examination, which must be carried out without fail, is electroencephalography. It gives medical professionals an idea of the extent of damage to brain cells.
If stupor is confirmed, hospitalization is usually indicated. In the hospital, the patient will be able to provide support for the functions necessary for life, and conduct a more detailed diagnosis.
Afterelectroencephalography, a spectral blood test is performed to detect a high sugar index and other provocateurs of a pathological condition. If intoxication is suspected, a blood test is also done, urine is examined for the presence of narcotic substances in the body. In some cases, the neurologist prescribes a lumbar puncture and magnetic resonance therapy of the brain.
Principles of treating stupor
Soporous condition, the consequences of which can be very severe, is not an independent phenomenon. It indicates a malfunction of the brain. Therefore, the goal of treatment should be to eliminate the underlying factor. In this case, therapy should be started as soon as possible.
Ischemia and swelling of the brain tissue often acts as a trigger for stupor. Early treatment prevents the brain from wedging into the natural openings of the skull and helps preserve the functionality of neurons.
Especially vulnerable are the nerve cells in the penumbra (ischemic penumbra). This is an area that is adjacent to the affected focus in the brain. Improper treatment provokes an increase in symptoms due to the death of neurons in this area. In this case, the soporous state may turn into a coma, and neurological disorders will become more pronounced.
In the treatment of stupor, the main actions are aimed at combating swelling of the nervous tissue, maintaining proper blood circulation in the brain. The level of glucose in the blood is also corrected, the lack oftrace elements, the causes of disruption of the heart, kidneys and liver are eliminated.
In case of infection, the use of antibiotics is indicated, and in the presence of hemorrhages, they resort to stopping bleeding.
With stupor, all drugs are injected into the body intravenously. At the same time, the most effective drug is glucose 40% and thiamine, as well as the use of these drugs with naloxone.
Further treatment of sopor depends on the degree of damage to the body and is prescribed by a doctor on an individual basis.
