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PubMed2001

[Diagnosis and differential diagnosis of consciousness disorders from the psychiatric viewpoint].

Diagnosis and differential diagnosis of disturbance of consciousness are often difficult, especially when occurring in the course of psychiatric diseases. Apart from discord in defining the term of consciousness it is not always easy to distinguish between qualitative and quantitative alterations of the disorders. The performance of an exact interview and a thorough clinical examination allows an estimation of the degree of dimming of consciousness as well as the possible causes. Disorder of Consciousness is often found in patients carrying out substance abuse but also in the course of other psychiatric diseases such as depression, schizophrenia, personality disorders and dissociative disorders. This article is dealing with the clinical approach towards patients experiencing alterations or disturbances of consciousness and is also trying to communicate innovations in the field of psychiatric diagnostics.

Alcoholic Intoxication↗
PubMedDate not supplied

[Diagnostic value of 24-hour simultaneous EEG and ECG monitoring of patients with heart diseases and atypical consciousness disorders].

In 24 patients with diagnostically not clear, short, recurrent episodes of consciousness disturbances and heart diseases and/or a history of arrhythmia simultaneous 24-hour recording was done of eeg and ecg. In the differential diagnosis epilepsy was considered, especially since in most cases routine eeg records demonstrated slight episodic changes. During 24-hour recording in 8 cases typical episodes of consciousness disturbances developed but in none of them these episodes were associated with arrhythmia which ruled out their cardiogenic origin. In 2 cases EEG recording served for establishing the diagnosis of partial complex seizures, 2 patients had hyperventilation syncope, one had TIA, in the remaining 3 cases absence of eeg and ecg changes during these episodes and coexistence of anxiety neurosis suggested functional origin. So the combined 24-hour eeg+ecg recording made possible establishing of diagnosis in 1/3 of these patients, enabling adequate treatment to be instituted.

Adolescent↗
PubMed2002

[ABC--DER TIP--STIMMT. Primary assessment of consciousness disorders].

A unconscious patient produces fear for laymen and uncertainty for professionals. Because acute changes in consciousness, that means changes in alertness or thinking, are challenges for every physician. Therefore the assessment of a unconscious patient demand a structural action. In this paper a reliable procedure is proposed in three steps. As a mnemonic serves the sentence "ABC (1st step)--DER TIP (2nd step)--STIMMT (3rd step)". The first step contains the ABC, which is usual in emergency medicine. In the second step neurological and other disabilities are noticed. An in the third step one tries, related to the findings from step one and two as well as from further examinations (CCT, lumbal puncture, lab-examines, ...), to find potential reasons for the unconsciousness of a patient.

Abbreviations as Topic↗
PubMed1975

[Consciousness disorders in focal lesions of the right and left cerebral hemispheres].

In the light of modern concepts of functional asymmetry in the human brain, the authors analyse paroxysmal conditions of changed consciousness which occurred in 160 patients with lesions of the hemispheres due to brain tumors (75 patients) and in epilepsy (85 patients). It is shown that certain forms of changed consciousness are characteristic of disorders of the right and left hemispheres in right-handedness. This clinical fact is taken as a basis for the assumption that in the formation of consciousness both hemispheres in different ways play a certain role and they provide different "formating" kinds of consciousness: the right hemisphere--a direct perception or a sensory perception of the environment and itself, the left--process of abstract perception based on speech, symbols, semantics.

Brain Neoplasms↗
PubMed1995

[Causes of disorders of consciousness in internal medicine intensive care units].

The present study on 5330 patients admitted to the internal intensive care unit over the five year period (1990-1994) indicated that consciousness disorders are most frequently associated with poisoning. On admission, the state of consciousness of 665 of these 5330 patients was retrospectively evaluated. Poisoning by drugs was most common among intoxications (93 patients of 154 cases of poisoning). Coma, which is the most severe manifestation of consciousness disorder, occurred very often in these patients. Poisoning caused by other agents was connected with other forms of consciousness disorders. Low Glasgow Coma Score (GCS) was a severe predictor, while the number of deaths among patients with GCS > 10 was low. Sepsis was the next most common cause of consciousness disorder among our patients (88 patients). Death rate in these patients was high, amounting to almost 50%, regardless of GCS on admission, suggesting that the severity of main event determines the outcome. Glycemia disorders, including hypoglycemia, hyperglycemia as well as hyperosmotic state, did not result in lethal outcome, regardless of GCS on admission. The highest death rate was registered in patients with cardiopulmonary arrest and lowest GCS on admission. Patients with cardiogenic shock, despite high GCS on admission, had high death rate.

Coma↗