The usual clinical stupor is manifested in a depressed psychological state of the patient, a weak reaction of the pupils to light and a dullness of pain.
A soporous state can transform into a coma, which is an extreme degree of inhibition of all body functions. It completely shuts off at a reflex level. In order to prevent this condition, one should know what provokes the appearance of a stupor.
What is the difference between stupor and coma
The main difference between sopor and coma is that the first condition is non-contact with the outside world, accompanied by loss of consciousness. But a person can be brought out of him at least for a short time. This can be achieved with 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 awakening is impossible. A person in a coma does not even respond to pain.
Reason for Sopor
The most common causes of stupor include:
- complications caused by cerebral hemorrhage;
- the presence of benign or malignant neoplasms in the brain;
- chronic diseases;
- toxic damage to the body;
- viruses and infections;
- thrombophlebitis;
- atherosclerosis;
- overdose of drugs, especially tranquilizers;
- wrong lifestyle;
- violation of metabolic processes in the body;
- severe hypertensive crisis;
- head injury;
- pronounced deviations of the glucose indicator in diabetes;
- decreased thyroid function (hypothyroidism);
- metabolic disorders in jade;
- rupture of aneurysm;
- poisoning of the body with carbon monoxide, barbiturates, opioids;
- meningitis;
- meningoencephalitis;
- heart ischemia;
- blood poisoning (sepsis);
- violation of the electrolyte balance in the body;
- heatstroke.
Symptoms of the disease
If a healthy central nervous system constantly responds to changing environmental conditions, then in a state of stupor, brain activity is inhibited. The body seems to be in a long sleep. A soporous state can transform into a coma.
The brain cannot make any decisions. Wakefulness and sleep can dramatically change each other.
Many people are interested in: "How long does the stingy state last?" Shutdown periods can last from a few seconds to months. It all depends on the cause of the process.
When stiffened, the patient may feel some blurry, confused understanding of everything that happens around. He may manifest disorientation in space. The patient may confuse dates and names, not remember the events that occurred yesterday, but at the same time, distinctive pictures of the distant past pop up in his memory.
Strong irritants can cause a reaction in humans. A sharp sound causes the opening of the eyelids, but the patient deliberately does not look for anything. Exposure to the nail bed provokes a jerking of the limb. An injection, patting on the cheek can cause a short-term negative reaction in the patient.
On examination, a decrease in muscle tone and inhibition of deep reflexes is noted. Often pyramidal syndrome is detected, caused by the suppression of central neurons. The reaction of the pupils to light is characterized by lethargy, 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 a soporotic state is provoked by a stroke or meningoencephalitis, then stiff neck muscles and other meningeal symptoms will be detected. Uncontrolled muscle twitching may also occur.
In some cases, doctors are faced with a hyperkinetic variant of stupor, in which a person says something incoherently, flips around, makes purposeful movements. Establishing productive contact with the patient is not possible. This condition is similar to delirium, which belongs to the category of qualitative impairment of consciousness.
A sore state after a stroke can be characterized by a high degree of emotion or by complete indifference to everything around.
Stroke with a stroke
Stroke is a very dangerous disease that causes unpredictable complications. Sopor is one of them. Translated from Latin, the word "stupor" means "dream", "numbness", "lethargy", "memory loss". In medicine, this condition is called subcoma, since it is a step towards the development of coma and is largely similar to this serious condition.
The stingy state of a 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 effects of apoplexy is more than a day. A stroke can lead to quick death.
Sopor is not always, but often enough accompanies a stroke. It is noted in approximately 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.
It is impossible to ignore such a complication under any circumstances, since most often it quickly turns into a coma.
The clinical picture of stupor in stroke
The soporotic state of a stroke, the prognosis of which depends on the prevalence of cerebral necrosis, manifests itself in the patient's drowsiness and lethargy. In parallel with this, protective reactions to irritants such as pain, sharp sound and light are preserved. The patient does not respond to his surroundings, cannot answer questions, is unable to complete any task. Muscle tension in the extremities is reduced, tendon reflexes are blunted, coordination of movements is lost.
Sopor in epilepsy
A stop 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 healthy 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 patient's emotional background. 2-3 days before a seizure, a person becomes excited, tense and anxious. Some patients become isolated, others show aggression towards others. Shortly before the attack, an aura arises, which is difficult to describe in words. It is characterized by a variety of tactile sensations: a taste in the mouth, vague sounds and smells. We can say that the aura marks an epileptic seizure.
In the cerebral cortex, a person has a focus of excitement. It covers more and more nerve cells. The end result is a seizure. Typically, the duration of the phase is 30 seconds, less often one minute. The patient’s muscles are in great tension. The head throws back. The patient screams, respiratory arrest occurs.
The convulsive stage lasts up to 5 minutes. With it, all the muscles of the patient involuntarily contract. After the seizure, the muscles relax again. The patient’s consciousness is turned off. The soporotic state of epilepsy lasts 15-30 minutes. After exiting the sopor, the patient falls into a deep sleep.
Sopor during dehydration
Such a complication as stupor can accompany dehydration. In medicine, water deficiency is commonly called exicosis. In this condition, a low content of electrolytes and water is observed, which is provoked by repeated persistent vomiting and severe upset stomach.
In addition, fluid loss can be caused by pathological processes in the kidneys and lungs. Usually, exicosis develops gradually within 2-3 days from the onset of the provoking disease.
Dehydration is characterized by lethargy of the patient, loss of appetite, refusal to drink. Liquid intake causes profuse vomiting. There is a decrease in muscle tone, the patient's body temperature, like pressure, drops sharply. Oliguria or anuria is noted.
A sore state from dehydration can turn into a coma.
Sopor prediction
What is the outcome of the disease? A soporotic state, the prognosis of which depends on the provoking cause, should undergo timely treatment. A large role is played by the degree of damage to the nervous tissue and the volume of therapy.
The sooner measures have been taken to correct the disorder, the higher the patient’s chance of restoring clear consciousness and regressing the symptoms of the underlying disease.
Diagnostics
Stroke caused by a stroke can be fatal. At the first mild manifestations of complications, timely diagnosis is necessary.
Priority measures include:
- blood pressure measurement;
- checking heart rate and respiration;
- 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 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 healthcare providers an idea of the extent of brain cell damage.
In the case of confirmation of the presence of stupor, as a rule, hospitalization is indicated. In the hospital, the patient will be able to provide support for the functions necessary for life, and conduct a more detailed diagnosis.
After electroencephalography, a spectral analysis of the blood is performed to identify a high rate of sugar and other provocateurs of the 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, a neuropathologist prescribes lumbar puncture and magnetic resonance therapy of the brain.
The principles of treatment of sopor
A soporotic state, the consequences of which can be very serious, is not an independent phenomenon. It indicates a violation 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.
The trigger mechanism of the sopor is often ischemia and swelling of the brain tissue. Early treatment prevents the wedging of the brain into the natural openings of the skull and helps maintain the functionality of neurons.
Especially vulnerable are nerve cells in the penumbra (ischemic partial shade). This is the 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 can turn into a coma, and neurological disorders will become more pronounced.
In the treatment of sopor, the main actions are aimed at combating edema of the nervous tissue, maintaining full blood circulation in the brain. Also, the level of glucose in the blood is corrected, the lack of trace elements is compensated, the causes of impaired functioning of the heart, kidneys and liver are eliminated.
When infection is indicated, the use of antibiotics is indicated, and in the presence of hemorrhages, they stop bleeding.
With sopor, all drugs are administered intravenously. In this case, the most effective drug is glucose 40% and thiamine, as well as the use of these funds with naloxone.
Further therapy of sopor depends on the degree of damage to the body and is prescribed by the doctor individually.