Delirium - what is it? Etiology of delirium. Treatment and consequences

Delirium - what is it? Science has its own definition - it is an exogenous psychosis, which has a short-term character. Most often lasts from several hours to several days. The origin can be:

• Infectious;
• Intoxication;
• Cardiovascular;
• Traumatic.

The etiology of delirium and its pathogenesis

Delirium (what it is, you can learn from the article) most often develops when:

• Alcoholism (called "white fever");
• Drug addiction (narcotic delirium);
• Infectious diseases of severe severity (with critical changes in body temperature);
• Intoxications (including medicinal products);
• Senile dementia ;
• Diseases of the cardiovascular system (hypertension, stroke, convulsive seizures);
• Craniocerebral trauma or severe blood loss;
• Transferred operations (delirium is promoted by stress, insomnia, fever).

Patients who have already suffered a similar condition under similar conditions tend to repeat the situation.

Common symptoms of delirium

As a rule, the beginning of such a state 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;
• The patient's consciousness is confused, disorientation.

When these symptoms occur, it can be said that the state of delirium has come. A person in this state can confuse dreams and reality because of a disturbance in the cyclicity of the period of sleep and wakefulness. Dreams and true hallucinations are also indistinguishable to patients. The attention is diminished, irrelevant incentives can switch it easily enough. In addition, other thinking processes slow down significantly. A person may not remember what happened to him during the period of delirium, or perceive it as a dream due to the memorization of only individual pieces.

Diagnosis of the disease

There are certain criteria that help diagnose delirium:

1. Involuntary attention, the patient is not able to concentrate on a particular subject. For example, such a person needs to repeat the question many times to hear an answer to it.
2. Disorganization of thinking, which is expressed in the fact that the patient with delirium jumps from one subject to another or says incomprehensible to the surrounding utterances.
3. A decrease in the level of consciousness (difficulty in maintaining the state of wakefulness during the day), perceptual disturbances (impossibility of awareness, illusion or hallucinations, colorful dreams that are perceived by the patient as a reality), disturbance of the cyclicity of sleep and wakefulness, increased psychomotor activity or, conversely, , Memory impairment. These criteria may not be present simultaneously, but only one of them.
4. The development of the state of delirium in the shortest possible time. Usually it does not exceed several days.
5. Disorientation in time.

Features of diagnosing the disease

Delirium is characterized by a rapid and sudden appearance of symptoms, which allows you to diagnose the disease at home. Typical changes in the severity of a certain symptom throughout the day. To facilitate the diagnosis will help accurate knowledge of the presence of any head trauma or a particular physical or infectious disease, as well as alcoholism or drug addiction.

Delirium (what it is, described earlier) refers to diseases that are amenable to treatment. If the cause that caused it is found in time, then the treatment can yield positive results. In some situations, the disease goes on its own, but do not let the situation run its course, as complications are possible.

Rules for the treatment of delirium

If the diagnosis of "delirium" is diagnosed, the treatment must necessarily be performed by a doctor. The main principle of treatment is the determination of the cause of the onset. After that, the analysis is collected and their outpatient study. Based on the results, the doctor prescribes medication or surgical treatment.

In addition to eliminating the causes of delirium, for example, treatment of alcoholism, activities are carried out that are aimed at facilitating the course of the disease, as well as preventing possible complications. For this, the patient is supported by a certain diet, as well as a balance of electrolyte 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 process of recovery it is very important to provide the patient with comfortable living conditions.

For example, treatment of alcoholic delirium occurs according to the following scheme:

• Reception of "Sibazon" and "Sodium oxybutyrate";
• Adjustment of electrolyte balance;
• Normalization of respiration 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 frightened or aggressive, sedatives are prescribed (which ones and their dosage are determined by the attending physician).

Alcohol delirium and its characteristics

Alcoholism, along with other terrible conditions of the patient, can be observed alcoholic delirium, or, in other words, white fever.

Alcoholic delirium (the symptoms are similar to those of another origin) is an acute psychosis under the influence of alcohol. This state is characterized by sudden disorders of consciousness, terrible hallucinations, disorientation in space and time, delirium, inexplicable fear and aggression, as well as a strong arousal.

Such a condition, as a rule, comes two days after the patient stops drinking. In some cases, there is also a very drunken period. The first attack of alcoholic delirium may occur after a long enough period of drinking-bout. All subsequent attacks do not require a long drinking-bout.

How to recognize the white fever?

The delirium syndrome is easy to recognize because there are certain signs:

1. The patient ceases to consume alcohol after drinking because of the fact that he was disgusted.
2. 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.
3. The trembling of the limbs is increasing.
4. There are problems with sleep. He becomes restless and short-lived, often the patient sees nightmares. After this, absolute insomnia may occur, which increases the feeling of fear, anxiety, and anxiety.
5. There are hallucinations both auditory and visual. The patient may begin to hear different voices that allegedly intimidate him. The visual images that arise are quite intimidating. Every day the scale of these hallucinations increases.

Such a condition in a person suffering from alcoholism can last up to several days.

Symptoms of alcoholic delirium

The main symptoms of delirium of alcohol origin are:

1. Visual hallucinations. Most often, the attack begins in the evening and progresses quite quickly. A person begins to see visual imaginary images, taking shadows from things for monsters. Hallucinations depend on the fears of the patient. In some situations, these hallucinations are not perceived by man as a reality, but rather resemble a movie.
2. Auditory hallucinations. They arise not separately, but, as a rule, in combination with 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 happening around him, he wants to help, but he is mortally afraid of doing it. Sometimes he can conduct a dialogue with imaginary interlocutors.
3. Tactile hallucinations. The movements and facial expressions of a person with alcoholic delirium fully correspond to those visions that persecute him. The patient begins to repulse from those monsters, which he sees, to brush off from them, to hide, to be hammered into a corner. In addition, such a person clearly feels how he is bitten, beaten, or otherwise causes pain. In such moments, he poses a great danger to others, as he can grab a thing and supposedly start saving someone. Another negative result may be suicide, which is an attempt to escape from those voices that the patient hears within itself.
4. Disorientation in time and space. The state of delirium is characterized by erroneous orientation both in space and in time. The patient may not know exactly where he is, does not recognize his relatives, the orientation in time is also broken. However, you can name the name, name or other data without any difficulty.

As a rule, if the patient has a true delirium, the symptoms intensify in the evening. In the afternoon, the condition may slightly improve, but you should not refuse treatment.

There are periods when the patient almost completely disappears manifestations of delirium. This condition is called the lucoid gap. At this time, the patient can easily tell about all the hallucinations that he had.

Possible consequences

If delirium is not treated (what is it, it is indicated at the beginning of the article), it can lead to complications, in particular to physiological changes:

• Increase in temperature, in some cases up to 40 degrees;
• Increased pressure, irregular heart rate;
• Dehydration of the body;
• Increased acidity;
• Difficulty in movement;
• tremor;
• Chills with alternation of sweating, sometimes smell of unwashed feet;
• Enlargement of the liver;
• Pallor of the skin or, conversely, its redness.

If you do not start treatment of delirium in time, these changes can not be avoided. With the manifestation of these complications, one can speak of the irreversibility of the process.

Very often, the cause of death of alcohol delirium is concomitant diseases such as pneumonia (accompanied by 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 (necrosis of skeletal muscles).

Prevention of delirium

In order to protect themselves against the possible manifestation of delirium of different origin, it is necessary to carry out preventive maintenance. It includes the following activities:

• Maintaining a healthy lifestyle in life, in particular the treatment of alcohol and drug addiction;
• Timely and correct treatment of various neurological and somatic diseases in order to avoid possible complications;
• Deliberate use of medications, refusal to self-medicate, in particular antidepressants, hypnotics, tranquilizers;
• Careful care for patients in the postoperative period, especially for elderly people.

What kind of doctors can help?

If you suspect the development of your relatives or friends delirium, contact a neurologist or an expert in narcology. Then to avoid undesirable consequences necessarily it will be possible.