Twilight stupefaction (syn. twilight disorder of consciousness ) - a type of impaired consciousness that occurs suddenly and manifests itself as a deep disorientation in the surrounding space with the safety of the usual automated actions.
Content
Description
It usually occurs suddenly, does not last long, and suddenly ends, so this disorder is called transient, transient [1] .
It is accompanied by speech-motor agitation or outwardly ordered behavior, the affect of fear, longing, anger, acute figurative delirium and a sudden influx of hallucinations [1] . Hallucinations are usually intimidating (mostly visual). The delusions that arise at the same time (often prosecution , less often greatness ) determine the patient's behavior. Aggressive destructive actions directed both at people (including close relatives) and at inanimate objects are very frequent [1] .
The duration of the state of confusion in epileptics is quite long - up to several days [2] .
Characteristic is complete forgetting of the period of dull consciousness ( total amnesia ). With this disorder, in contrast to delirium and onyroid , there are even no memories of subjective experiences [1] .
Options for Twilight Clouding
The clinic distinguishes the following types of twilight stupefaction:
- A crazy option . Externally, the patientβs behavior is ordered, nevertheless, silence, an absent look and a special concentration are characteristic [1] [2] . Aggressive destructive actions that a patient in this condition can produce can give the impression of premeditated and planned actions [1] . After exiting the state of confusion, the patient treats the committed acts as being alien to his personality [1] .
- Hallucinatory option . The prevalence of hallucinatory experiences is characteristic. The expressed state of excitement with aggressive and destructive actions [1] . In practice, most often found in patients with epilepsy [2] . Psychosis usually begins with illusions, and then hallucinations (visual, auditory, general feelings) appear [2] . Patients can see blood, red color, sparks, often hallucinations take on a frightening character [2] . Patients experience horror and inflict crushing blows, as a rule, even several healthy and strong people cannot hold them [3] [2] .
- Oriented (dysphoric) twilight confusion . The depth of confusion fluctuates, often an elementary orientation in the environment is preserved, patients can recognize familiar people [1] . There are fragments of self-awareness [1] . Hallucinations and delusions are either completely absent or episodic [1] . Typical affect of fear and anger [1] .
- Outpatient automatism - twilight stupefaction without hallucinations, delusions and changes in emotions [1] . Patients with this disorder perform automated actions and movements. They can make unconscious journeys along the street, and quite long: a case of a patient traveling from Mumbai (Bombay) to Calcutta in a state of mental automatism is known [2] .
- A pre-sleep state is a violation of consciousness and perception caused by a sharp awakening from the phase of slow sleep (usually at the beginning of sleep). It is accompanied by increased aggressiveness, inability to adequately perceive the environment. Affect is possible. The condition is short-lived, almost always a person forgets the events that occurred at this moment. Occasionally, even in healthy people, if the dream was very strong, and the irritant was strong.
Typical pathologies
It occurs in epilepsy , organic brain diseases, less commonly in traumatic brain injuries . Also, the twilight state of consciousness can be caused by toxic substances, such as antifreeze (a solution of ethylene glycol and other glycols)
Notes
- β 1 2 3 4 5 6 7 8 9 10 11 12 13 Psychiatry Manual / Ed. A.V. Snezhnevsky . - M .: Medicine, 1983. - T. 1. - S. 63-64. - 480 p.
- β 1 2 3 4 5 6 7 B. D. Tsygankov, S. A. Ovsyannikov. Psychiatry: a guide for doctors. - M .: GEOTAR-Media, 2011 .-- S. 213-215.
- β V. A. Gilyarovsky, 1935