Delirium - what is it? Science has its own definition - it is an exogenous psychosis, which has a short-term character. 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 learn from the article) most often develops when:
- alcoholism (has the name "delirious tremens");
- drug addiction (narcotic delirium);
- infectious diseases of severe severity (with critical changes in body temperature);
- intoxications (including medicinal ones);
- senile dementia;
- diseases of the cardiovascular system (hypertension, stroke, seizures);
- traumatic brain injury or severe blood loss;
- surgeries (delirium is promoted by stress, insomnia, fever).
Patients who have already suffered a similar condition, under similar conditions, tend to repeat the situation.
General symptoms of delirium
As a rule, the beginning of suchstate comes in an acute form. However, if delirium occurs, some symptoms may signal its onset. They are called prodromes. These include:
- unjustified concern;
- alarm;
- feeling fear;
- increased sensitivity to light or sound;
- confused patient's mind, disorientation.
When these symptoms occur, we can say that the state of delirium has come. A person in this state can confuse dreams and reality due to a violation of the cyclical period of sleep and wakefulness. Also, patients are indistinguishable dreams and true hallucinations. Attention decreases, irrelevant stimuli can easily switch it. In addition, other thought processes are significantly slowed down. A person may not remember what happened to him during the period of delirium, or perceive it as a dream due to remembering only separate pieces.
Diagnosis of disease
There are certain criteria that help diagnose delirium:
- Involuntary attention, the patient is unable to concentrate on a particular subject. For example, such a person needs to repeat a question many times in order to hear an answer to it.
- Disorganization of thinking, which is expressed in the fact that a patient with delirium jumps from one subject to another or says statements incomprehensible to the surrounding people.
- Decreased level of consciousness (difficulty staying awake during daytime), perceptualviolations (the impossibility of awareness, an illusion or hallucinations, colorful dreams that are perceived by the patient as a reality), a violation of the cyclical sleep and wakefulness, an increase in 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 the state of delirium in the shortest possible time. Usually it does not exceed several days.
- Time disorientation.
Features of diagnosing a disease
Delirium is characterized by a 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 of the presence of any head injury or a specific physical or infectious disease, as well as alcoholism or drug addiction will help facilitate diagnosis.
Delirium (what it is, described earlier) refers to diseases that can be treated. If the cause that caused it is detected in time, then the ongoing treatment can give positive results. In some situations, the disease goes away on its own, but you should not let the situation take its course, as complications are possible.
Rules for the treatment of delirium
If a diagnosis of delirium is made, treatment must be carried out by a doctor without fail. The main principle of treatment is to determine the cause of the occurrence. After that, the collection of analyzes and their outpatient examination is carried out. Basedthe results obtained, the doctor prescribes medical or surgical treatment.
In addition to eliminating the cause of delirium, for example, the treatment of alcoholism, measures are taken to alleviate the course of the disease, as well as to prevent possible complications. To do this, patients are supported by a certain diet, as well as the balance of electrolytes in fluids.
In addition to the cause of delirium, the choice of treatment is influenced by the environment in which the symptoms appeared, the age of the patient and his neurological status. During the recovery process, it is very important to provide the patient with comfortable living conditions.
For example, the treatment of alcoholic delirium is as follows:
- reception of "Sibazon" and "Sodium oxybutyrate";
- rebalancing electrolytes;
- normalizing breathing and lung function (using the drug "Mannit");
- restoration of the liver and kidneys;
- reducing or eliminating hyperthermia;
- treatment of comorbidities.
For patients who are frightened or aggressive, sedatives are prescribed (which ones and their dosage is determined by the attending physician).
Alcoholic delirium and its characteristics
In alcoholism, along with other terrible conditions of the patient, there may be alcoholic delirium, or, in other words, delirium tremens.
Alcoholic delirium (symptoms are similar to conditions of other origin) is an acute psychosis underthe influence of alcohol. This condition is characterized by sudden disturbances of consciousness, terrible hallucinations, disorientation in space and time, delirium, inexplicable fear and aggression, as well as severe arousal.
This condition, as a rule, occurs two days after the patient stops drinking. In some cases, it is also observed during the drinking period itself. The first attack of alcoholic delirium may occur after a sufficiently long period of drinking. All subsequent attacks do not require prolonged drinking.
How to recognize delirium tremens?
Delirium syndrome is easy enough to recognize, because there are certain signs:
- The patient stops drinking alcohol after a binge due to the fact that he is disgusted.
- In the evening there is a change of mood, and quite suddenly. During this period, the patient may be too excited and restless, chatting incessantly, does not find a place for himself.
- The trembling of the limbs increases.
- Having trouble sleeping. It becomes restless and short-term, often the patient sees nightmares. After that, absolute insomnia may occur, which contributes to increased feelings of fear, anxiety and anxiety.
- Hallucinations appear, both auditory and visual. The patient may begin to hear various voices that allegedly intimidate him. The visual images that arise are quite frightening. The scale of these hallucinations is increasing every day.
This condition in a person suffering from alcoholism can last up to severaldays.
Delirium alcoholic symptoms
The main symptoms of alcoholic delirium are:
- Visual hallucinations. Most often, the attack begins in the evening and progresses quickly enough. A person begins to see visual imaginary images, taking the shadows from things for monsters. Hallucinations depend on the fears of the patient. In some situations, these hallucinations are not perceived by a person 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 theme. The patient may hear various rustlings, screams, fictitious requests for help or warnings. It seems to him that something very bad is happening around, 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 alcoholic delirium are fully consistent with the visions that haunt him. The patient begins to push away from those monsters that he sees, brush them off, hide, hide in a corner. In addition, such a person clearly feels that he is 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 can be suicide, which is an attempt to get away from the voices that the patient hears inside himself.
- Disorientation duringtime and space. The state of delirium is characterized by an erroneous orientation both in space and in time. The patient may not know where exactly he is, does not recognize his relatives, orientation in time is also impaired. However, he can give his last name, first name or other data without any difficulty.
As a rule, if the patient has a true delirium, the symptoms increase in the evening. During the day, the condition may improve slightly, but you still should not refuse treatment.
There are periods when the patient's symptoms 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 left untreated, delirium (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;
- high blood pressure, irregular heart rate;
- dehydration;
- increase in acidity;
- difficulty in movement;
- tremor;
- chills with alternating sweating, sometimes smell of unwashed feet;
- enlarged liver;
- paleness of the skin or, conversely, its redness.
If delirium is not treated 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 death from alcoholic delirium is comorbidities, such as pneumonia (accompanies severe delirium in 30% of cases), cardiomyopathy (heart failure), acute pancreatitis (one of the most common comorbidities of alcoholic delirium), acute renal failure, cerebral edema, rhabdomyolysis (skeletal muscle necrosis).
Prevention of delirium
In order to protect yourself from the possible manifestation of delirium of various origins, you need to carry out prevention. It includes the following activities:
- maintaining a he althy lifestyle, in particular the treatment of alcoholism and drug addiction;
- timely and correct treatment of various neurological and somatic diseases to avoid possible complications;
- conscious use of medications, refusal of self-medication, in particular antidepressants, sleeping pills, tranquilizers;
- careful postoperative care, especially for the elderly.
Which doctors can help?
If you suspect the development of delirium in your family or friends, contact a neurologist or narcologist. Then it will be possible to avoid undesirable consequences.
