Hysterical fit or exhaustion of the nervous system. How to treat hysterical psychopathy

A hysterical seizure or attack is an acute reaction of a person to a super-powerful emotional stimulus or event. A certain protest, which includes not only a mental, but also a physical component in order to influence a certain situation, in conditions that do not meet the requirements or expectations of such a person.

However, despite the fact that it is based on provocation and the desire to influence others or change the situation as a whole, it cannot be said for one hundred percent that a person completely controls his consciousness and state during such an attack. Therefore, help with a hysterical fit should be provided on time, in order to avoid serious consequences for the health of such a person.

Most often, a hysterical seizure occurs in women and children. Symptoms may resemble other acute conditions. The general picture is reduced to the following complaints, which are characteristic of both hysterical and epileptic seizures:

• uncoordinated, complex movements;
• wringing of limbs;
• hair pulling;
• arching the body into an arc;
• coordination disorders;
• hiccups, belching;
• spasm, vomiting;
• violations of cardiac activity and pulse;
• senseless walking or running;
• repetition of the same phrases.

However, there are clear differences between an epileptic seizure and a hysterical one.

1. A fall in hysterics never harms the patient, he falls extremely gently. With epileptic - injuries are often observed due to the complete uncontrollability of the condition.
2. With hysteria, there is no discharge from the mouth, the tongue does not bite and never sinks.
3. Consciousness is not completely lost only in hysteria. The person remembers the attack and does not fall asleep after it.
4. In hysteria, cases of involuntary urination or defecation are extremely rare.
5. There is no excessive sweating in hysteria. The pupils react to light during a hysterical attack.
6. After the completion of a hysterical attack, patients may say that they "do not understand" what happened to them, "sincerely surprised." After hysteria, facial contractions, hiccups, or trembling may persist. All this goes away after sleep.

Unlike withdrawal symptoms, hysterical patients never ask for any treatment or pills. But patients with withdrawal are always “in the know” what and in what doses he needs to apply.

However, hysteroids are able to further think out and diagnose some dangerous and incurable disease in themselves, provoking even more attention to their person. Therefore, if bouts of hysteria are repeated, it is imperative to contact a psychologist.

Hysterical seizures in women are usually associated with hysteroid accentuation in general. Such representatives of the fair sex are already emotional and tend to attract everyone's attention. Therefore, when providing first aid for a hysterical fit, be sure to try to remain cool, calm others and not encourage further such behavior with concessions and unfavorable compromises. Otherwise, there is a chance that such attacks will become rather the norm of a reaction in case of disagreement. Remember: the more "spectators" watching the attack, the longer it takes.

What needs to be done?

First aid:

• try to isolate the person from strangers, ideally - move to a separate room;
• give a sniff of ammonia;
• do not react emotionally to what is happening, be silent;
• ideally, calmly observe a person, the fact is that against the background of a seizure, attempts of self-harm or thoughtless acts of a suicidal nature may occur, which must be prevented.

What can not be done?

• engage in a discussion or yell at a person;
• leave it unattended to avoid deterioration or acts of self-harm;
• by force to hold the limbs or head of such a person so as not to lead to dislocation of the joints;
• crowd around a large number of people, cry, lament or call for help from others.

The last point should be especially considered in the context of the appeal of one client, whose wife, with all sorts of quarrels and disagreements, was prone to such attacks. At the same time, the young family lived together with the wife's parents and her grandmother. And at the peak of the attack, the wife’s mother usually began to cry and lament loudly, calling all the household members and blaming the man for “bringing his daughter to this.”

Such a reaction immediately led to a distinct convulsive hysterical fit, when the woman began to arch unnaturally. Long-term therapy, which contributes to the separation of a woman from her family, as from “additional viewers”, contributed to the complete cessation of such reactions.

Practicing psychologists often describe female clients whose relatives came with cases of a hysterical attack. In this case, as a rule, the first appeals occur to other specialists: neuropathologists, for example. The suspiciousness of such patients has already been mentioned. Therefore, in the case of personal appeals, they go the way most often from surgeons or neurosurgeons, cardiologists and psychiatrists. However, it is psychologists who are able to offer a number of techniques that can not help during the attack itself, but pay attention to other aspects of the personality, which are the basis for such reactions.

It is also worth paying attention to the relatives of such people. In connection with the initial appeals not to the relevant specialists, the final verdict or diagnosis is delayed and goes, rather, by excluding more serious diseases. Therefore, such patients often tend to turn to alternative medicine, fortunetellers, healers and psychics. And they recognize hysterical personalities well and can profit from such sessions, skillfully manipulating the client's expectations.

Signs of childhood hysteria

Hysterical seizures in children are associated primarily with the immaturity of the nervous system and the inability of the child to verbalize his disagreement.

However, such seizures may also be associated with:

As a rule, the first case of a seizure can be observed in a child at 2 years of age. And go to three years. If, after this, a similar trend is observed, then it is worth contacting a psychologist.

Signs of a fit of hysteria in children are similar to the main ones described above. With the difference that the "convulsive bridge" in young children is observed more often. They also tend to inflict various minor injuries on themselves: scratching their faces, hitting their heads or on the head. In addition, the child often tries to hit the parent who is nearby. And in most cases - mom. This is what distinguishes a similar condition in babies from adult seizures, which often pass "bloodlessly" and without injury to the patient.

Condition Correction

First aid for hysteria in children should also be carried out without outside witnesses and in a place where the child is least likely to be injured. Pull your baby away from corners and door frames, as well as sharp and fragile objects.

Try to remove the scarf from the child, if there is one, and a hat with ties. This is important so that the baby does not strangle himself. And most importantly, but the most difficult - do everything to remain calm yourself.

Screaming and proving to a child in this state is a waste of energy. It is necessary to wait for the end of the seizure. After him, the children feel physically exhausted. They just need to be hugged and pitied. If the child is pushed away, then new inappropriate behavior or reaction can be provoked: hiccups, new attempts at self-harm, stuttering and much more.

It is important not only what you did with hysteria in a child. It is necessary to behave correctly and consciously after it. Speak out what happened so that the child hears that the same thing can be calmly said in words, without exhausting tantrums. Emphasize how such things upset you and tire him. And do not forget to still insist on your own, on what this “emotional protest” began with: after all, do not buy this toy or do something: give it away, take it away.

A hysterical seizure is a type that is manifested by an indicative emotional state (tears, screaming, loud laughter, arching of the back, wringing of the limbs), as well as convulsive and temporary.

This type of disease has been known to scientists since ancient times. For example, Hippocrates carefully studied this phenomenon and called it "womb rabies", because this is a completely logical explanation.

It is known that hysterical seizures of this kind are observed in most cases in females, they are much less common in children and practically never occur among men.

Modern researchers associate the disease with individual personality traits (character, temperament). The risk group includes those people who are prone to suggestion, fantasizing, they have an unstable type of behavior and changeable mood. In order to somehow attract the attention of others, they resort to committing such non-standard acts.

In the event that the disease is not diagnosed in a timely manner and its symptoms increase and become more pronounced over time, then only a qualified psychiatrist should be treated. In each case, the treatment is compiled individually and must be followed until complete recovery.

Factors provoking the development of hysteria

Like every mental illness, the main reason for the development of hysteria are violations that occur in the standard behavior of the individual. This should also include upbringing, character, temperament and resistance to suggestion.

In most cases, a hysterical fit can be caused by human infantilism, hysterical manifestations of character, as well as a genetic predisposition to this type of disorder.

Seizures can be triggered by a variety of factors, including:

• the presence of severe diseases of internal organs in a person;
• frequent physical overexertion;
• professional activity that does not bring due satisfaction;
• frequent conflicts and quarrels in the family circle;
• recent trauma;
• regular use of alcoholic beverages;
• improper use of medications;
• frequent stressful situations and nervous strain.

Scientists have proved the fact that this disease can manifest itself only in people with certain character traits. So, for a personality in which certain traits do not appear under the influence of adverse factors, it will soon begin to develop.

It has been proven that hysteria is a state that cannot arise abruptly, it requires a certain kind of preparation (for example, as with actors, before a performance).

What does it look like in real life?

A hysterical seizure is characterized by a number of different symptoms. We list the main ones:

At the same time, such manifestations of an attack of hysteria are also observed:

• the quality of vision and hearing deteriorates significantly;
• there is a narrowing of the field of vision of a person;
• hysterical blindness is manifested, which affects 1 or both eyes at once;
• deafness (temporary);
• the patient's voice ceases to be clear and sonorous (aphonia);
• dumbness appears;
• a person begins to speak in syllables;
• stuttering;
• during an attack, paralysis of individual limbs or the entire body develops ();
• the muscles of the tongue, neck and face become paralyzed;
• bending the body in the opposite direction (in the form of an arc).

A patient who is characterized by frequent hysterical seizures is characterized by the manifestation of the following symptoms:

• refusal to eat;
• inability to swallow food on their own;
• vomiting and nausea (psychogenic origin);
• frequent belching, coughing and yawning.
• the presence of flatulence;
• shortness of breath, which in most cases resembles an attack of bronchial asthma.

First aid

To provide first aid in case of a hysterical seizure, the following rules must be followed:

• you need to try to calm all the people around;
• after this, the patient will need to be moved to a quieter place;
• it is desirable that there are as few people as possible nearby;
• if possible, give a sniff of alcohol (ammonia);
• you should not stand too close to the person, but it is important to keep a distance so that he can see you.

• leave a person at the time of a hysterical attack;
• forcibly hold the arms, neck, legs and head of the patient;
• shout at the patient.

Smart problem solving

The main task of treating a hysterical seizure is to get rid of the causes that provoked it. To do this, you will definitely need the help of a psychotherapist.

According to an individually designed program, he will conduct psychotherapeutic classes, which will consist of various trainings, hypnosis and suggestion.

Also, the treatment of hysteria is accompanied by the use of psychotropic and restorative drugs. They allow not only to strengthen the immune system of the patient, but also contribute to the normalization of his mental state.

As an additional therapy, bromine preparations, Andeksin, Librium, minimal doses of Reserpine and Aminazine are prescribed.

It is strictly forbidden to cancel the medication or change the dosage on your own! Drug treatment is carried out under the strict supervision of the attending physician!

Good results in the treatment of an attack of hysteria help to achieve traditional medicine. They are not only absolutely safe for human health, but also help to restore the vitality of the patient's body. So, for example, before going to bed it will be very useful to drink a cup of decoction based on motherwort, chamomile, mint, lemon balm or valerian.

The use of these herbs is contraindicated only in case of individual intolerance or in the presence of allergic reactions.

Before using traditional methods of treatment, it is imperative to consult with a specialist. It is important to find out if these herbs are compatible with the components of the drugs used.

Say no to hysteria

Prevention of a hysterical fit mainly consists in the fact that all relatives who surround the patient show their usual attitude towards him.

This means that you should not show excessive hyper-custody, because the patient can understand everything wrong, which will become the reason for the next manifestation of a hysterical state. Walking in the fresh air and engaging in some kind of calm and soothing activity will be useful.

It is important to remember that a favorable and positive atmosphere should always be present in the family (quarrels and scandals can only aggravate the course of the disease).

Paroxysms - short-term, sudden onset and abruptly ending disorders prone to stereotypic repetition. The most common paroxysms due to epilepsy and organic diseases with epileptiform symptoms(tumors, vascular diseases, injuries, infections and intoxications). It is sometimes necessary to distinguish from epileptic seizures hysterical seizures and paroxysmal attacks of anxiety and fear (panic attacks).

Epileptic (and epileptiform) seizures - This manifestation of an organic brain lesion, as a result of which the entire brain or its individual parts are involved in pathological rhythmic activity, recorded as specific complexes on the EEG. Pathological activity may be expressed by loss of consciousness, convulsions, episodes of hallucinations, delusions or absurd behavior.

Characteristic signs of epileptic (and epileptiform) paroxysms:

spontaneity (lack of provoking factors);

sudden onset;

relatively short duration (seconds, minutes, sometimes tens of minutes);

sudden cessation, sometimes through the sleep phase;

stereotyping and repetition.

The specific symptomatology of a seizure depends on which parts of the brain are involved in pathological activity. It is customary to divide seizures into generalized and partial (focal).

Generalized seizures , under which all parts of the brain at the same time are susceptible to pathological activity, manifest loss of consciousness(sometimes general convulsions). In patients no memories left about a seizure.

Partial seizures never do not lead to complete loss of consciousness, patients have individual memories about the paroxysm pathological activity arises only in one part of the brain. So, occipital epilepsy is manifested by periods of blindness or flashes and flashes in the eyes, temporal epilepsy - by episodes of hallucinations (auditory, olfactory, visual), damage to the precentral gyrus - by unilateral convulsions in one of the limbs (Jackson's seizures). The partial nature of the seizure is also indicated by the presence of precursors (unpleasant sensations in the body that occur a few minutes or hours before the attack) and aura (the short initial phase of the seizure, which is stored in the patient's memory). Physicians pay special attention to partial seizures because they may be the first manifestation of focal brain lesions, such as tumors.

Seizures are usually classified according to their underlying clinical manifestations.

Epileptic paroxysms include:

large convulsive seizures (grand mal, clonic-tonic seizures);

small seizures (petit mal, simple and complex absences, myoclonic seizures);

twilight clouding of consciousness (ambulatory automatisms, somnambulism, trances, hallucinatory-delusional variant);

dysphoria;

special states of consciousness (psychosensory seizures, attacks of "déjà vu" and "jame vu", paroxysms of delusional and hallucinatory structures);

Jacksonian seizures with convulsions in one of the limbs.

Grand mal seizures (Grandmal) - This seizures lasting up to 2 minutes, manifested by loss of consciousness and convulsions. Loss of consciousness in this case reaches the degree of coma (all types of reflexes are absent: pain, tendon, pupillary). A major seizure usually begins suddenly, only sometimes a few seconds before losing consciousness, patients experience aura in the form of separate delusions of perception ( smell, visual images, discomfort in the body, nausea), movement disorders or emotional disturbances ( feelings of anxiety, anger, confusion, or happiness).

At the beginning of an attack arise tonic convulsions: all the muscles of the body contract at the same time. At the same time, the patient falls sharply, which can cause injury, is sometimes observed piercing cry.

After 10-30 s appear clonic convulsions, all muscles relax at the same time, and then contract again and again, which is manifested by characteristic rocking movements. During clonic convulsions, the patient not breathing, so the initial pallor of the face is replaced by cyanosis. During this period, the patient may pass urine, bite tongue often foaming at the mouth.

Clonic seizures may continue from 30 s to 1.5 min then sick comes to consciousness.

Usually within 2-3 hours after the seizure the patient experiences fatigue and drowsiness.

In a grand mal seizure there is always high chance of injury due to a sudden fall and clonic convulsive movements.

Small seizures (petitemal) - Very short (less than a minute) attacks of turning off consciousness, not accompanied by convulsions and falling. With small seizures never no aura seen, the patients themselves do not remember anything about the attack, don't notice him. Others describe small seizures as short-term episodes of blackout, when the patient suddenly becomes silent, he has a strange "floating" absent look This disorder is called absence(from fr. absence - absence). Sometimes the picture of absence is supplemented by a short movement: a bow, nod, turn, tipping back (complex absence). In this case, patients can drop objects from their hands, break dishes.

In adolescence small seizures are often manifested by repetitive shuddering, twitching; such seizures are called myoclonic seizures. Patients themselves do not notice them, relatives may not attach importance to this disorder or even consider it a bad habit.

Twilight obscurations of consciousness described in detail in the previous section. The main feature of the disorder is this is a paroxysmal disturbance of consciousness, manifested by relatively complex actions and deeds, followed by complete amnesia of the entire period of psychosis.

Dysphoria - This brief outbursts of angry-depressive mood with irritation, sullenness, grumbling, outbursts of anger, verbal abuse, or even dangerous aggressive behavior. Outbreaks occur unexpectedly, do not always reflect the real situation. Characteristically gradual accumulation of discontent followed by a sharp discharge of emotions when all the accumulated irritation is realized in the behavior of the patient. In contrast to the twilight stupefaction of the patient's consciousness does not amnesiac a period of excitation, can subsequently quite accurately describe their actions. Calming down, he often apologizes for their actions.

Special states of consciousness , like dysphoria, not accompanied by complete amnesia, which indicates the partial nature of the seizures. Symptoms may vary, however in the same patient, all painful phenomena are stereotypically repeated so that each subsequent attack is similar to all previous ones. Some patients have sensory disturbances in the form of changes in the size, shape, color, position in space of observed objects and violations of the body scheme (psychosensory seizures), others may experience attacks of derealization and depersonalization of the type "already seen" (déjà vu) and "never not seen” (jame vu) or brief episodes of delusions and hallucinations. Although with all the listed variants of paroxysms, consciousness is not completely turned off, however, the patients' memories of an attack are incomplete, fragmentary; their own experiences are better remembered, while the actions and statements of others may not be imprinted in the memory.

Hysterical reactions- this is a number of disorders of the mental, sensitive and motor spheres that arise in connection with an overstrain of the main physiological processes in the cerebral cortex. More often they are observed in hysteria, sometimes in other mental illnesses (schizophrenia, involutive psychoses).

Etiology of a hysterical seizure. In the development of a hysterical fit, the leading role belongs to the action of an external factor that injures the psyche or indirectly weakens it.

The pathogenesis of seizures in hysteria associated with the emergence of psychogenic dysfunction in the cortical structures and formations of the hypothalamic-limbic-reticular complex.

Clinic (signs) of a hysterical seizure (convulsions)

A distinctive feature of hysterical symptoms is theatricality, demonstrative manifestations, the attack intensifies or drags on when people gather around the patient.

Attack begins suddenly, without an aura, against the background of a conflict situation and, as a rule, is not accompanied by a loss of consciousness (unlike an epileptic seizure), but there may also be its twilight stupefaction. Memories of the seizure and its surroundings are usually preserved, but fragmentary. The seizure lasts from several minutes to several hours and is characterized by various motor manifestations. Patients usually do not fall, but slowly sink to the floor without causing serious injury to themselves.

Arise chaotic semi-voluntary movements, which at the same time are diverse, complex and expressive: patients squirm, beat their heads, tear their hair, clothes, clench their teeth, tremble, roll on the floor, scream, repeat the same phrase. The appearance of a "hysterical arc" is typical, when the patient leans on the surface only with the heels and the back of the head, and the body is curved in an arc. The control of the function of the pelvic organs is preserved. Urinary incontinence is sometimes observed, but involuntary defecation does not occur. The eyelids are usually tightly compressed and the patient resists an attempt to open them. The shape of the pupils is not changed, their reaction to light and painful stimuli is within the normal range. When brought to the face of cotton wool moistened with ammonia, it is possible to cause a protective reaction. Frequent shallow breathing is characteristic. Pronounced hemodynamic changes are usually not observed. Often, patients develop hysterical mutism (muteness), functional changes in the auditory and visual apparatus, which are manifested by the inability to perceive complex stimuli, but with the preservation of an elementary unconditional reaction.

Others may be noted functional changes in the CNS: inability to walk in the absence of objective signs of paresis (hysterical paralysis); anesthesia of areas by the type of stockings or gloves, which does not correspond to the zones of innervation.

Thanks to the preserved consciousness, patients are suggestible. A change in the external situation, lack of attention and interest from others can cause a gradual relief of a seizure. The seizure can be suddenly terminated by the action of a strong stimulus (prick, sharp sound, splashing of cold water), which distinguishes it from an epileptic seizure, which cannot be stopped by such measures. Differentiate a hysterical fit from epileptic also allows the absence of stereotyped repetition, sequence of development, selection of tonic and clonic phases, biting of the tongue. Sleep usually does not occur after the seizure ends.

It must be remembered that hysterical reaction can be manifested by a state of lethargy, the so-called psychotic stupor, characterized by complete immobilization and muscle relaxation. At the same time, there is no reaction to painful stimuli, the expression of suffering freezes on the face, the patients breathe heavily and noisily. Gradually, breathing becomes shallow, the pulse quickens. In appearance, the patient may resemble the deceased, so earlier this condition was called "imaginary death."

seizure

A seizure is the result of an uncontrolled sudden influx of electrical energy into the brain, in simple terms, it is a kind of short circuit.

In the event of even short-term convulsive seizures, you should immediately consult a doctor. Leading doctors of Russia, luminaries of medicine, practice in the Yusupov hospital, who will quickly determine the cause of seizures and prescribe a course of effective treatment.

Waiting and self-treatment in this case is the wrong and risky choice, which over time can lead to serious and bleak consequences.

Some seizures are very short-term and have a mild character. At the same time, they can go unnoticed even for those people who have them.

In many cases, convulsive seizures present a terrifying picture: a person falls to the floor, foam comes out of his mouth, legs and arms convulse.

Seizures are distinguished from partial seizures (It occurs due to abnormal electrical activity of neurons in a certain area of ​​the brain) and generalized seizures. Its occurrence is associated with abnormal electrical activity of nerve cells scattered in the brain.

Causes of seizures

Seizures can occur for a number of reasons. In young children, seizures can be a sign of infectious diseases, in particular, the spread of the infectious process to the cells of the brain and its membranes. They can also be the result of high body temperature.

In people of any age group, seizures can occur after:

• stroke
• epilepsy;
• traumatic brain injury;
• neuroinfections;
• tumors.

Separately, a form of convulsions is distinguished - a hysterical seizure. It is most commonly seen in teenagers and young women. Particular attention is paid to convulsive seizures in pregnant women. It can occur due to late severe toxicosis.

The causes of seizures are also drug or alcohol withdrawal, more precisely the withdrawal syndrome, as well as a change in the regimen of taking certain anticonvulsants and an overdose of certain medications.

In some cases, in order to get rid of the resulting seizures, doctors recommend that patients change their lifestyle, but in most cases, a course of therapy is still required.

Neurologists at the Yusupov Hospital develop a treatment regimen for each patient on an individual basis, taking into account a number of factors.

Treatment of seizures

In case of any convulsive seizure, regardless of the degree of its severity, it is necessary to call an ambulance.

Only an experienced doctor can distinguish a hysterical seizure from a true convulsive one. In all other cases, it must be considered as a possible epileptic one and the patient's condition should be treated with full seriousness and responsibility.

First of all, it is necessary to protect the patient from injuries and damage at the time of a convulsive seizure. To do this, put a soft pillow or folded clothes under your head. It is also necessary to put something soft under the legs and arms.

In no case should foreign objects be inserted between the patient's teeth - spoons, forks and others, since at the time of convulsions they can provoke respiratory arrest or lead to a foreign body entering the respiratory tract (broken tooth crown and others).

If a seizure is observed in a child, then before the arrival of an ambulance, it is necessary to apply a cold compress to his forehead and in the area of ​​\u200b\u200bthe right hypochondrium. It is also allowed to give the child an antipyretic.

Treatment of seizures in the Yusupov hospital

In the Yusupov hospital, patients are received 24 hours a day, 7 days a week. Doctors will quickly and efficiently diagnose, determine the cause of seizures and prescribe a course of effective treatment. The clinic accepts patients from 18 years of age and older.

After a seizure, patients need to be hospitalized. The wards of the Yusupov hospital are equipped with modern medical equipment, appliances, comfortable furniture, which makes the patient's stay in the hospital comfortable. The professionalism of the doctors of the Yusupov hospital allows "putting patients on their feet" in a short time and avoiding complications and recurrent seizures.

In no case should convulsions be ignored, they do not go away on their own, seizures will recur more often, and the disease will begin to progress. Timely medical intervention for convulsive seizures is very important in order to avoid the development of severe pathologies.

You can make an appointment at the Yusupov Hospital by phone.

Recognition of an epileptic seizure

There are a number of paroxysmal syndromes that may bear a distant resemblance to an epileptic seizure. When a physician directly observes a seizure, only rarely can there be diagnostic doubt in this regard. But it is not often necessary to directly observe an epileptic seizure. Much more often it is necessary to judge the nature of the attack on the basis of a story about him or the patient himself or those around him, and then such doubts can often arise.

The following is a list of paroxysmal conditions which may somewhat resemble an epileptic seizure and which must always be kept in mind in this recognition.

Hysteria. Convulsive seizures during hysteria are currently observed among our patients much less frequently than they used to be, which, of course, was the result of both the penetration of advanced socialist culture into the broadest sections of our population, and the result of a more correct view of doctors on the essence and causes of hysteria. . Nevertheless, even now it is occasionally necessary to see large convulsive fits of a hysterical nature.

Not so long ago, the differentiation of hysterical seizures from epileptic seizures presented considerable difficulties and served as a pretext for a large number of special studies. Nowadays, hardly any experienced doctor can doubt the nature of the observed seizure - there are too many differences between seizures of one kind and another, explained by the fact that in one case convulsions are an automatic discharge of nervous energy played out in the motor analyzer, and in In another case, it is the result of a complex emotional conflict in a person with a pronounced imbalance in signaling systems. This is where all the differences come from.

An epileptic seizure, as we have seen above, may sometimes develop in connection with a psychic experience such as surprise, fright, etc., but for the most part it occurs unexpectedly and "spontaneously." A hysterical fit is an affective reaction - the patient reacts this way to much more complex life experiences - an insult to someone, annoyance at others, some kind of life failure, grief, etc.

With an epileptic seizure, consciousness is completely lost, and no contact with the patient is possible. In a fit of hysteria, however, some contact with the patient can still be made, and when such a patient is convulsing, he begins to beat more strongly if they try to restrain him. If, during a convulsive seizure, the patient inflicted severe damage on himself, it was certainly an epileptic seizure.

Convulsions in epilepsy are inexpressive and meaningless, just as the cry is inexpressive and meaningless, often emitted by the patient at the first moment of an attack. Convulsions in hysteria are more coordinated and expressive. These are not contractions of certain muscles, but certain actions. Instead of an unmodulated epileptic scream, the patient with hysteria cries expressively, sobs or groans during an attack.

The pupils during an epileptic seizure lose their light reaction, which is preserved during a hysterical seizure. The extinction of tendon reflexes and the appearance of pathological reflexes in hysteria are not observed. Tongue biting always speaks for epilepsy. Of course, a patient with hysteria can, of course, urinate under himself during an attack, but this is extremely rare.

Hysterical seizures are longer than epileptic seizures. They are also more polymorphic than epileptic seizures, which are much more stereotypical.

Patients also behave differently at the end of the seizure. While a patient with epilepsy usually does not come to his senses after losing consciousness immediately, but for some time is not able to correctly orient himself in his environment and experiences general weakness and headache, a patient with hysteria, waking up after a seizure, immediately returns to his normal state, and sometimes he even feels some calm or relief after the nervous discharge that has occurred.

In this differential diagnosis, one can also take into account the fact that hysterical seizures never occur in a state of sleep and never occur if the patient is completely alone.

It has been repeatedly pointed out that there are apparently no strictly pathognomonic individual symptoms to distinguish these seizures from each other, and that such a diagnosis should always be based on a comprehensive assessment. The latter is true, although it should be borne in mind that until recently the attribution of such obviously organic symptoms to a hysterical fit, such as, for example, loss of pupillary light reactions, etc., was apparently based on the fact that at that time many , then not yet known variants of an epileptic seizure passed for hysteria.

In disputable cases, the detection of characteristic changes in the biocurrents of the brain outside the seizures contributes to the resolution of the issue.

If, therefore, it is not difficult to distinguish a seizure of epilepsy from a seizure of hysteria for the most part, then the situation changes significantly when we have before us some less common variants of an epileptic seizure, and especially manifestations of mesencephalic, diencephalic or mesodiencephalic epilepsy.

With seizures of this kind, patients are usually in a clear mind. With fear, they notice a number of very unpleasant and hard-to-experience symptoms, such as shortness of breath, palpitations, chills, cold extremities, diarrhea and painful cramps in different parts of the body. They usually give a natural emotive reaction to all these symptoms, often crying, rushing about, cannot find a place for themselves and ask for help. All this can easily give an impression of hysteria to an inexperienced doctor. However, on closer examination, we are able to notice in relation to these seizures that they differ fundamentally from the emotive discharges in hysteria. Tonic convulsions in mesencephalic crises do not express anything, and vegetative symptoms in diencephalic crises go far beyond the vegetative symptomatology of emotions. In addition, both meso and diencephalic seizures are completely devoid of that element, as it were, of deliberate pretense, from which not a single manifestation of hysterical neurosis is completely free.

Sometimes it is more difficult to distinguish the state of epileptic automatism from the somewhat similar symptoms of hysteria. Such a difficulty can arise in those (rare) cases when the actions performed during epileptic automatism are not just inconsistently absurd, but add up to more formalized behavior. Thus, one of our patients with epilepsy during such states always sought to hug and kiss neighboring patients. Obviously, here the automatic behavior of the patient was dictated by the old temporal connections she had, and this gave the first impression of experiencing some kind of complex mental conflict. Diagnosis of such complex states of automatism is possible only in a complex manner, taking into account all other features of the disease and its course.

Until recently, the difficulties in diagnosing between epilepsy and hysteria led to the fact that they tried to substantiate the idea of ​​some kind of combined or transitional form, which was called "hystero-epilepsy". The modern elucidation of fundamentally different mechanisms underlying one and the other disease, of course, makes the idea of ​​such transitional forms incompetent, and the diagnosis of "hystero-epilepsy" should never be made. On the other hand, it is not uncommon for there to be combinations, combinations of both diseases in the same person. It is the patients with epilepsy, especially if the seizure proceeds with their consciousness preserved, that they can also give hysterical seizures, which are, as it were, a psychogenic imitation of their main seizures. Such combinations have been noted more than once in diencephalic and mesodiencephalic seizures. However, it was usually not difficult to distinguish real seizures from their hysterical imitation. Elucidation of the main hysterical background of the higher nervous activity of these patients, as well as the presence of other manifestations of suggestibility and hysteria in them, facilitates this diagnosis.

Fainting. Of the other paroxysmal disorders of consciousness, which may be a reason for confusion with epilepsy, general vasomotor syncope should be indicated. (syncope). It is necessary to remember the following features of it: when fainting, the patient does not lose consciousness immediately, but gradually, and before losing consciousness, he becomes “ill” for some time, darkens before his eyes, he experiences dizziness, general weakness, nausea; during a faint, the patient's face turns pale sharply, the pulse becomes slightly tense; no convulsions, no biting of the tongue, no involuntary urination occurs during a syncope. The patient comes to his senses after vasomotor syncope also not immediately, but gradually. Often, when a patient lying after a faint raises his head, he becomes ill again, it gets dark in his eyes, and he again has to lie down for a while, since in a horizontal position the still remaining anemia of the brain does not reach such a degree.

Fainting is often provoked by bad air (a smoky, unventilated room), as well as fear associated with pain, as in various medical procedures (subcutaneous injections, tooth extraction, etc.). The sight of blood in impressionable people sometimes provokes dizziness and can lead to fainting.

With all these features, vasomotor syncope differs sharply from disturbances of consciousness of epileptic origin.

Similarly, short attacks of hypertension, the so-called "cerebral vascular crises", can sometimes be mistaken for epileptic discharges. After dizziness or a short loss of consciousness, mild symptoms of prolapse may remain, in the form, for example, of temporary speech disorders or temporary paresis, etc. And since such attacks can be repeated in some cases, this, naturally, may lead the doctor to think about seizures of focal epilepsy. These states differ from epileptic seizures, in addition to the presence of significant arterial hypertension, also by the persistence of residual symptoms between seizures.

Seizures of loss of consciousness, sometimes with convulsions, developing on the basis of anemia of the brain in Adams-Stokes syndrome, differ from epilepsy in the presence of a sharp violation of the medium-vascular activity (bradycardia, transient ventricular fibrillation due to atrioventricular blockade).

Some similarity with an epileptic seizure may further have various variations of the so-called intentional convulsions, or Rülf's syndrome. These are peculiar, short convulsive discharges provoked by unprepared active movement. Such patients must therefore begin every new movement very cautiously and gradually, especially after the preceding phase of rest. At the same time, the convulsive seizure itself can be either more cortical or more subcortical in nature. In the first case, a spasm, starting with a muscle group that has entered an active state, then spreads to neighboring segments, following the contiguity of cortical fields and in this respect resembling a Jackson-type spasm. In the second case, the spasm immediately spreads more diffusely, resembling motor activity during athetosis and differing from athetosis only in that the process proceeds here in the form of separate paroxysms associated with active innervation.

Consciousness in an intentional spasm, unlike an epileptic seizure, is never disturbed. A peculiar difference is that the intentional spasm usually disturbs patients very little, who, having adapted to their defect, often cope with the requirements of everyday life perfectly.

The pathophysiological basis of this peculiar syndrome differs significantly from the mechanism of the epileptic discharge. It is here that, along with the increased excitability of the motor analyzer, the lack of concentration of the excitatory process clearly comes to the fore. In these patients, the process of surrounding the working sections of the motor analyzer with negative induction occurs very slowly, and it takes some time for the excitation focus in the hemispheric cortex to be well delineated and so that the excitation from this focus does not spread to adjacent sections. It should be said that the diagnosis of epilepsy in these cases can present certain difficulties, especially since in some cases an intentional spasm can be combined, for example, with epileptic seizures that occurred in childhood.

In some cases, the reason for possible confusion with a convulsive epileptic seizure may be the conditions of early contracture that develop in severe organic patients, if they occur in the form of separate short attacks. Such short convulsive paroxysms may closely resemble the seizures of mesencephalic epilepsy described above. The fundamental difference between these conditions can be that such a spasm is essentially a spontaneously occurring protective reflex spasm and that with it one can always detect a massively developed syndrome of protective reflexes, which is in no way characteristic of convulsions of an epileptic nature.

Special mention deserves the so-called dystonia of effort. This syndrome, which has not yet been fully studied at the present time, consists in short-term, but very massive convulsive installations such as torsion dystonia, which occur with every attempt by the patient to make some kind of movement, and here it is no longer required at all, as was the case with intentional convulsions, so that this movement was emergency, or unprepared. For example, the patient wants to raise his arm, but instead there is a tonic flexion cramp of the muscles of the trunk, etc.

This syndrome is described in extrapyramidal movement disorders. The sudden development of such a widespread tonic spasm may somewhat resemble the tonic variants of an epileptic seizure, but a closer study of this hyperkinesis immediately reveals its connection with active innervation and, therefore, a completely different mechanism of origin.

Similarly, other paroxysmal convulsions in extrapyramidal syndromes should be strictly distinguished from epilepsy. This includes numerous types of paroxysmal hyperkinesias that occur in the chronic phase of epidemic encephalitis, of which the so-called "gaze spasm" is most common. These are the characteristic "violent movements", the difference between which and epilepsy we spoke above, discussing the problem of the so-called "subcortical" or "striate" epilepsy. The so-called "facial paraspasm", which usually develops against the background of either cerebral arteriosclerosis, or against the background of encephalitis, also has nothing to do with epilepsy, although it can manifest itself in the form of separate convulsive paroxysms separated from each other by relatively light intervals. Common phenomena of the so-called "paradoxical kinesia" (appearance and disappearance of spasms in special motor conditions), often found in facial paraspasm, easily allow
to distinguish these forms of hyperkinesis from epileptiform conditions. These conditions are described in more detail in the "Local convulsions" section.

It is easy to distinguish from focal forms of epilepsy and the so-called facial hemispasm, although recent attempts have been made to combine these diseases. However, these attempts (for more on this, see the relevant section) were apparently based on the fact that they were based on not completely pure cases of facial hemispasm. Pure cases of this syndrome have a clearly different, non-epileptic origin: they are distinguished by a strictly sustained locality of the peripheral type, after each convulsive discharge they do not leave paresis, do not show characteristic changes in brain biocurrents and are not amenable to antiepileptic therapy.

Nocturnal epileptic seizures, especially in children, sometimes give rise to confusion with sleep enuresis. Help in recognizing these syndromes can be the fact that if a child suffering from enuresis urinated in bed at night, he wakes up in the morning completely healthy, sometimes feeling only natural embarrassment from what happened. On the contrary, after an epileptic seizure that occurred in a dream, the patient wakes up in the morning broken and with a headache.

Similarly, attacks of ordinary neurotic sleepwalking should be distinguished from attacks of epileptic automatism, as discussed above.

Seizures of so-called static epilepsy can have a very great similarity with attacks of cataplexy, especially since we often do not observe them directly, but only know about them from the stories of the patients themselves or those around them.

To distinguish between these seizures, it is important to remember that attacks of cataplexy are usually directly provoked by some (often pleasant) emotion, and also that patients suffering from cataplexy, as a constant rule, also exhibit episodic falling asleep in the form of characteristic attacks of narcolepsy. In addition, the attack of static epilepsy lasts mostly shorter than the attack of cataplexy.

Distinguishing epileptic sleep attacks from narcoleptic seizures is usually not difficult: epileptic sleep attacks are much longer, while the dream itself is much deeper.

In those cases where an epileptic seizure begins with a vestibular aura, and such an aura can appear in isolation, naturally, a very difficult question sometimes arises about the difference between these conditions and attacks of Meniere's vertigo. Diagnosis can often be only complex here, taking into account other signs of epilepsy. One of the diagnostic signs, apparently, can also be the fact that dizziness in epileptic vestibular aura does not depend on one or another position of the head and is not accompanied by such a strong autonomic repercussion as in angioedema vestibular crises.

An epileptic seizure differs from a migraine attack in such a large number of signs that, it would seem, diagnostic difficulties should not arise here. Nevertheless, in a number of observations it turns out that some manifestations of the so-called associated migraine can closely resemble epileptic auras.

For example, pre-seizure hemiparesthesias or scotomas in migraine can give rise to confusion. One of the good differential diagnostic signs can be the different speed of symptom generalization in these conditions: a migraine focal symptom spreads through the cortex much more slowly. Thus, it was pointed out that migraine paresthesias that began, for example, in the hand, require tens of minutes to spread throughout half of the body, while a similar syndrome in Jacksonian epilepsy develops much faster. The slowness with which migraine atrial scotoma spreads across the visual field is also well known.

In some cases, there may still be certain diagnostic difficulties. Thus, Kissel, Arnoux, and Hartmann recently described the observation of a girl who, during menstruation, had either migraine attacks or epilepsy attacks, both of which were preceded by the same visual aura. It is remarkable that the same aura could be observed in her in an isolated form. On this occasion, we can also recall the observation of Shavani, in which attacks of ophthalmic migraine and epilepsy with visual aura alternated.

All these separate elements of similarity between both diseases are probably explained by the fact that although the closest mechanism for the appearance of one and the other disease remains unknown to us, nevertheless, there is obviously some pathogenetic relationship between them. This can be seen at least from the frequency of secondary cases of migraine in families from which patients with epilepsy come, as well as from the relatively high frequency of a combination of epilepsy and migraines in the same person. The relationship of both diseases is also confirmed pharmacologically. So, it turned out that in the presence of migraine, the smallest dose of cardiazole is enough to cause an epileptic seizure.

Finally, it should be borne in mind that attacks of a special state of consciousness can give rise to diagnostic errors. Indeed, somewhat similar states can be observed in neuroses. These are short-term and usually completely identical disturbances of consciousness that sometimes occur in those suffering from neurosis, each time under the influence of some stereotypical external cause. Such reasons include various situations that require either a very strong concentration of attention, or a very quick transition of attention from one to another. Such, for example, is the need to urgently switch attention in some new direction, sometimes in conditions of a decrease in the tone of the cortex, or the need to fix attention simultaneously in several directions, or simply the presence of a negative emotion. Patients speak in such cases of "stupefaction" or "inhibition", "fading thoughts", "remoteness", etc., i.e., they use definitions that are very close to those used by patients with epilepsy to describe their special states. Probably, these conditions are based on pathological irradiation of the inhibitory process through the cortex due to the weakness of internal inhibition.

These poorly understood conditions are often mistaken for epilepsy. They differ from epilepsy in a number of very significant ways.

Thus, these states always develop with an obvious reason, which contains a typical neurosogenic situation, namely: overstrain of nervous processes or their mobility. Further, these patients do not show other signs of epilepsy, but they constantly show a number of other neurasthenic symptoms. It is not possible to detect changes in the biocurrents of the brain in them, which are characteristic of epilepsy. Anti-epileptic treatment does not help them either, while therapy aimed at combating neurosis often brings them significant relief.

These "special states" of a neurotic nature must therefore always be kept in mind in order to avoid unwarranted overdiagnosis of epilepsy.

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The concept of epilepsy

Help at the onset of an attack

Help after an attack

The concept of a hysterical fit

How to stop a hysterical fit and tantrum

The concept of sleepwalking, or sleepwalkingAssistance with sleepwalking

Four commandments: how to reduce the likelihood of an epileptic seizure

CONCEPT ABOUT EPILEPSY

Epilepsy, or rather, epileptic seizures, was known to healers in antiquity. Many great commanders and emperors, artists and writers suffered from such attacks. The biographies of Julius Caesar, Napoleon and some Russian tsars do not hide cases of epilepsy.

People marked by this disease were considered to be the bearers of the divine gift (in the writings of Hippocrates, epilepsy is described as a sacred disease), then to the devil's offspring and the fiends of hell.

Many soothsayers and priests, sorcerers and shamans not only surprised the inhabitants with their predictions, but shocked them with their behavior during communication with otherworldly forces.

Indeed, an epileptic seizure causes fear and shock in a person who first saw it.

A sudden loud cry, a frozen, stretched out like a string, body (Greek epilepsia - means grasping, squeezing, tension) falls with a roar in terrible convulsions-convulsions.

Rapidly bluish face with wide, non-reactive pupils; breathing with a wheeze on inspiration and foamy, often mixed with blood, discharge from the mouth - all this cannot but cause horror among others. To top it all off, involuntary urination occurs.

The attack lasts no more than 3-5 minutes. After a seizure, the patient is insane for some time, finds his bearings with difficulty and cannot articulately answer a single question.

The most terrible thing lies elsewhere: the patient cannot remember what happened, but the stories about the details of the seizure have an extremely depressing effect on him.

A person is ashamed of his illness, afraid to make friends and avoids not only marriage, but also any intimacy. His illness becomes a family secret and the cross that he will carry all his life. Loneliness and a sense of inferiority - this is the fate of this unfortunate.

If relatives and others cannot understand his problems and do not stop focusing on a detailed description of attacks, then mental deviations, constant depression, alienation and loss of interest in life will become inevitable.

REMEMBER! The more fear a person experiences before a recurrence of a seizure, the more likely it is to occur.

SIGNS OF AN EPILEPTIC SEAL:

Sudden loss of consciousness with a characteristic scream before falling.

Seizures.

Foamy discharge from the mouth, often mixed with blood.

Wide pupils that do not react to light with the obligatory preservation of the pulse on the carotid artery.

Involuntary urination.

ASSISTING IN THE BEGINNING OF AN ATTACK

Of course, such a sudden and shocking onset of an attack can confuse even physicians, and wide, unresponsive pupils force one to think about clinical death and proceed to chest compressions - an extremely erroneous action in this situation.

REMEMBER! Wide pupils that do not respond to light with a preserved pulse on the carotid artery and convulsions throughout the body are reliable signs of an epileptic attack.

No matter how scared you are, you need to quickly run up to the patient and turn him on his side. Only in this position it is possible to prevent the tongue from sinking, the aspiration of saliva and blood, which sometimes flow profusely in case of a bite of the tongue.

Very often they make a gross mistake: they try to turn and tightly press only their heads to the floor - such an action is tantamount to murder.

REMEMBER! It is unacceptable to press to the floor or turn only the patient's head.

A convulsively twitching body and a head beating on the floor should be fixed in a completely different way.

First, turn the entire shoulder girdle on its side and lean on it with your whole body. Even to hold a sick child, the efforts of an adult are not enough.

Secondly, only after fixing the shoulder girdle, you can press the patient's head to the floor.

It is advisable to put under it rolled up clothes or a small pillow.

In this situation, it is necessary to protect the patient as much as possible from any injuries, so broken glass and sharp objects, furniture and even your own glasses should be as far away from you as possible.

REMEMBER! There is no need to take any measures to prevent biting of the tongue. There was not a single case of tongue biting. A bitten tongue heals for 2-3 days. But the bitten off fingers of an inept rescuer are not even isolated cases.

How to fix the head and shoulder girdle of the child
in case of an epileptic seizure

Turn the child on its side.

Sit on his shoulders

Gently press your head to the floor and wait for the attack to end

What to do? In cases of an epileptic seizure in an adult?
In the position of the patient “lying on his back”, press his shoulders to the floor with his body and hands until the attack ends.

UNACCEPTABLE!
Insert spoons or other metal objects into the patient's mouth.

The duel between metal and tooth has never ended in favor of bone tissue. A broken tooth is a foreign body in the larynx, and bleeding from its hole is another problem in an extremely dangerous situation.

IT IS FORBIDDEN!
Trying to insert wooden objects between the teeth.

Pencils and spatulas are unpredictable in their durability, and their fragments become murder weapons.

TO SAVE THE PATIENT DURING AN ATTACK
FROM ACCIDENTAL INJURY, IT IS NECESSARY TO MOVE FROM FURNITURE LEGS AS FAR AS POSSIBLE,
BROKEN GLASSES AND SHARP OBJECTS.

ASSISTANCE AFTER THE END OF THE ATTACK
Immediately after the cessation of convulsions and the restoration of calm breathing, consciousness begins to gradually return to the patient. He seems to wake up after a deep sleep: he does not recognize those around him, he cannot understand how he ended up in this place, his speech is slow, incoherent, it is impossible to get intelligible answers from him. However, a person is already able to stand up and move independently.

God forbid let him go in such a state. Neither traffic lights, nor police whistles, nor heart-rendingly screaming car horns will save him from death. He is not adequate in his reactions and actions.

REMEMBER! You can not release the patient immediately after the end of the attack.

He needs at least a short sleep, and in most cases the attack gradually turns into deep sleep: breathing evens out, convulsive twitches disappear, the face turns pink. It is only required to monitor the breathing of the sleeping person and come to his aid in time in case of a resumption of the attack. Only after 2-3 hours of deep sleep can you be sure of the complete cessation of the attack and the safety of the patient.

REMEMBER! In all cases of an epileptic seizure, you must call a doctor or an ambulance.

Very often, such an attack with loss of consciousness, convulsions and respiratory failure can be a manifestation of a number of serious diseases.

IN NO EVENT IS IMPOSSIBLE!
Hide epileptic seizures.

REMEMBER! Such an attack with a driver or pilot will certainly end in tragedy. At the same time, epilepsy has its own treatment, and very successful.

ASSISTANCE SCHEME
IN EPILEPTIC SEIZURES

UNACCEPTABLE!
Press to the floor or turn only the patient's head.

UNACCEPTABLE!
Release the patient without seeing a doctor.

THE CONCEPT OF A HYSTERIC JIT

REMEMBER! A hysterical fit is not a sight for the faint of heart.

The patient (women are more prone to this condition) rolls on the floor and beats her head, tearing her face and chest with her nails, tears her hair and clothes, bends in an arc, leaning on the floor with the back of her head and heels (hysterical arc), growls, yells, groans, shouting out what - some phrases, and this is not a complete list of actions that the hysterical fantasy is capable of.

Seizures can be so varied in their manifestations that it is not necessary to dwell on the description of how the patient will wring her hands and what will be erupted from her mouth (saliva or selective mat).

The main thing is that during a hysterical seizure, unlike an epileptic one, the pupils necessarily react to light and there is no involuntary urination and biting of the tongue.

REMEMBER! A hysterical fit is arranged in the presence of at least one spectator. The more spectators, the brighter the performance.

In Rus' and in some countries of Islam, there was a whole institution of semi-professional hysterical hysterics. It doesn't matter what made these women hysterical: money or religious fanaticism - the result was pogroms and riots, religious wars and civil unrest, lynching and mass executions.

History does not know a single example when the actions of a hysterical person led to noble and humane results.

The impact of a seizure on the layman is colossal, even contrary to common sense and human morality. The calls of psychopaths are aimed at committing the most vile deeds.

Unfortunately, even today, some unscrupulous political leaders willingly resort to hysterics when they lack logic and arguments.

REMEMBER! A hysterical fit is dangerous not so much for the patient as for others.

During an attack, the patient rarely inflicts serious injuries on herself: even falling to the floor, she will first choose a cleaner place and only then lie down.

The danger lies elsewhere: the sympathy of the audience kindles excitement in her and turns her on to such an extent that it is difficult for her to stop.

REMEMBER! The biggest evil of hysteria is the simplicity in achieving the goal: for the baby - getting the desired toy; adult - the fulfillment of his whim.

Having once known success in achieving the goal and believing in the reliability of this method, you can become a really sick person with a very bad character.

A child in this situation is like a domestic terrorist who has taken the peace of the whole family hostage. The criminal future of such offspring is beyond doubt.

HOW TO STOP
HYSTERIC FIT AND HYSTERIC

Breaking off a seizure, or rather, stopping the performance, is as easy as shelling pears: it is enough to remove the audience or suddenly hit the hysterical on the cheek, pour cold water over it, or suddenly drop something with a crash.

There will be an instant reaction: the patient shudders, looks around and is unlikely to continue her presentation.

To prevent the recurrence of the seizure, it is necessary to remove the patient from the crowd. In the presence of even a small injury, it is imperative to call an ambulance and consult a psychiatrist for the patient.

REMEMBER! Self-control, firmness and a little sarcasm in the perception of what is happening will help stop the tantrum.

ABOUT THE MAIN DIFFERENCES OF THE HYSTERIC FIT
FROM EPILEPTIC:

In hysterics, the consciousness and reaction of crustaceans to light are preserved.

During a hysterical seizure, the psychopath will necessarily designate a hysterical arc, which never occurs in epilepsy.

UNACCEPTABLE!
Go hysterical.

SCHEME OF HELP WITH A HYSTERIC SIT

THE CONCEPT ABOUT DREAMING OR SLEEPING

Sleepwalking, sleepwalking, or somnambulism (lat. somnus - sleep + ambulare - to walk, move around), is not so rare in our lives.

Most often this happens with a child who sits up in bed in the middle of the night, gets up and walks around the room, or performs any other habitual, fairly coordinated actions: dressing, washing, folding or sorting out objects, then returning to bed or lying down in another place and continues to sleep. . At the same time, the eyes are open, but the gaze is directed somewhere into the distance.

It is not surprising to be afraid of a lunatic. At the sight of a somnambulist wandering down the corridor, nightmare lovers' hair stands on end.

REMEMBER! A sharp shout or noise can scare a sleepwalker to death.

He instantly loses his balance and falls. A bloody broken face and stuttering are far from the most severe consequences of such an awakening.

DREAM ASSISTANCE

First of all, it is necessary to approach the child as quietly as possible, without turning on the light, and carefully, so that he does not wake up, take him by the arm and bring him to the bed. It is also advisable to carefully remove his clothes from him, put him in bed and cover him with a blanket.

There is nothing difficult in these actions. But if a child walks along the ledge or towards the railroad, many difficult problems arise.

As a rule, the next morning the child does not remember anything about what happened. Many in childhood at least once, but found themselves in a similar state. Sleepwalking in children cannot be considered a disease unless it recurs every night.

REMEMBER! Never tell a child about his nightly walks.

RULES FOR DREAM ASSISTANCE:

Quietly, trying not to wake up, approach the child from behind.

Gently take him by the arm and bring him to bed.

Lay down and cover with a blanket.

In the morning, in no case do not tell him about what happened.

If this happens again, consult a doctor.

By no means!
Wake up or turn on bright lights.

Unacceptable!
Talk about nightlife

Sleepwalkers
and chronic fatigue syndrome

Adult somnambulists, and even in broad daylight, is also a very likely phenomenon. With some forms of epilepsy and mental disorders, and more often with an extreme degree of overwork, a person suddenly discovers that he ended up in another city, but does not remember at all how this happened.

If something like this happened to you or your loved ones, then do not hesitate to contact a clinical psychologist. Most likely, this visit will force you to reconsider the workload and work schedule, which will completely eliminate such problems.

Shift workers, rescuers, long-distance drivers and aircraft crews are familiar with the expression “go to the autopilot”.

The person does not remember at all what happened to him on the way to work, how he handed over money for a ticket, answered some simple questions. Unthinkingly, on automatism, those actions were performed that were repeated many times.

There is a protective reaction of the nervous system when it is overloaded. Everyday, trivial information is discarded as unnecessary.

Such a selective reaction of your brain can be felt right now. You are completely oblivious to your clothes, shoes and wristwatch while reading this text. True, provided that these items do not cause any inconvenience. You just forget about them or don't pay any attention to them. For the cerebral cortex, this is unnecessary, redundant information. In case of severe overwork, this is your defensive reaction.

But when you “on autopilot” cross the road in an unspecified place, this is your death.

REMEMBER If you cannot remember how you entered the subway or train, if in a panic you run home to remove the pan from the fire or turn off the iron, and everything is turned off by you, then you enter chronic fatigue syndrome.

A person who enters this syndrome, on the automaticity of his actions, can make a very serious accident. The only sure and reliable way out of this situation is to take a vacation for 2-3 days and get enough sleep.

NO MAN
WHICH would not break at least once
turn off at home from work.
iron already turned off by him!

The expression “throw a tantrum” is used by us quite often, but few people think about the fact that this is not a simple behavioral promiscuity, but a real disease, with its symptoms, clinic and treatment.

What is a hysterical fit?

A hysterical seizure is a type of neurosis, manifested by indicative emotional states (tears, screams, laughter, arching, wringing of hands), convulsive hyperkinesis, periodic paralysis, etc. The disease has been known since antiquity, even Hippocrates described this disease, calling it "womb rabies", which has a very understandable explanation. Hysterical seizures are more typical for women, less often they disturb children and only as an exception occur in men.

Professor Jean-Martin Charcot demonstrates to students a woman in a hysterical fit

At the moment, the disease is associated with a certain personality warehouse. People who are prone to bouts of hysteria are suggestible and self-hypnotic, prone to fantasizing, unstable in behavior and mood, like to attract attention to themselves with extravagant actions, tend to show theatricality in public. Such people need spectators who will babysit and take care of them, then they get the necessary psychological relaxation.

Often, hysterical seizures are associated with other psychosomatic deviations: phobias, dislike for colors, numbers, pictures, conviction of a conspiracy against oneself. Hysteria affects approximately 7-9% of the world's population. Among these people there are those who suffer from a severe degree of hysteria - hysterical psychopathy. The seizures of such people are not a performance, but a real disease that you need to know, as well as be able to help such patients. Often, the first signs of hysteria appear already in childhood, so parents of children who react violently to everything, arch their backs, scream in a huff, should be shown to a pediatric neurologist.

In cases where the problem has been growing for years and an adult already suffers from pronounced hysterical neuroses, only a psychiatrist can help. Individually for each patient, an examination is carried out, an anamnesis is collected, tests are taken and, as a result, a specific treatment is prescribed that is suitable only for this patient. As a rule, these are several groups of drugs (hypnotics, tranquilizers, anxolytics) and psychotherapy.

Psychotherapy in this case is prescribed to reveal those life circumstances that influenced the development of the disease. With the help of it, they try to level their significance in human life.

Symptoms of hysteria

A hysterical seizure is characterized by an extreme variety of symptoms.

A hysterical seizure is characterized by an extreme variety of symptoms. This is explained by the self-hypnosis of patients, "thanks" to which patients can portray the clinic of almost any disease. Seizures occur in most cases after an emotional experience.

Hysteria is characterized by signs of "rationality", i.e. the patient has only the symptom that he "needs", "beneficial" at the moment.

Hysterical seizures begin with a hysterical paroxysm, which follows an unpleasant experience, a quarrel, indifference from loved ones. The seizure begins with the corresponding symptoms:

Crying, laughing, screaming

Pain in the region of the heart

Tachycardia (rapid heartbeat)

Feeling short of breath

Hysterical ball (feeling of a lump in the throat)

The patient falls, convulsions may occur

Hyperemia of the skin of the face, neck, chest

Eyes closed (when trying to open, the patient closes them again)

Sometimes patients tear their clothes, hair, beat their heads

It is worth noting the features that are not characteristic of a hysterical seizure: the patient does not have bruises, a bitten tongue, an attack never develops in a sleeping person, there is no involuntary urination, a person answers questions, there is no sleep.

Sensitivity disorders are very common. The patient temporarily ceases to feel parts of the body, sometimes he cannot move them, and sometimes he experiences wild pains in the body. The affected areas are always diverse, they can be limbs, the stomach, sometimes there is a feeling of a “driven nail” in a localized area of ​​​​the head. The degree of intensity of the sensitivity disorder is diffuse in nature - from mild discomfort to severe pain.

Disorder of the sense organs:

Visual and hearing impairment

Narrowing of the visual fields

Hysterical blindness (may be in one or both eyes)

hysterical deafness

• Hysterical aphonia (lack of sonority of voice)
• Silence (cannot utter sounds or words)
• Scanning (by syllables)
• Stuttering

A characteristic feature for speech disorders is the willing desire of the patient to enter into written contact.

• Paralysis (paresis)
• Inability to perform movements
• Unilateral hand paresis
• Paralysis of the muscles of the tongue, face, neck
• Trembling of the whole body or individual parts
• Nervous tics of facial muscles
• Arching the body

It should be noted that hysterical seizures do not mean real paralysis, but an elementary impossibility to make arbitrary movements. Often, hysterical paralysis, paresis, hyperkinesis during sleep disappear.

Disorder of internal organs:

• Lack of appetite
• Swallowing disorder
• psychogenic vomiting
• Nausea, belching, yawning, coughing, hiccups
• Pseudoappendicitis, flatulence
• Shortness of breath, imitation of an attack of bronchial asthma

The basis of mental disorders is the desire to be always in the center of attention, excessive emotionality, lethargy, psychotic stupor, tearfulness, a tendency to exaggerate and the desire to play a leading role among others. All the patient's behavior is characterized by theatricality, demonstrativeness, infantilism to some extent, it seems that the person is "happy with his illness."

Hysterical seizures in children

Symptomatic manifestations of mental seizures in children depend on the nature of the psychological trauma and on the patient's personal characteristics (suspiciousness, anxiety, hysteria).

The child is characterized by increased sensitivity, impressionability, suggestibility, egoism, mood instability, egocentrism. One of the main features is recognition among parents, peers, society, the so-called “family idol”.

For young children, breath holding is characteristic when crying, provoked by discontent, the anger of the child when his requests are not satisfied. At an older age, the symptoms are more diverse, sometimes resembling attacks of epilepsy, bronchial asthma, and suffocation. The seizure is characterized by theatricality, the duration until the child gets what he wants.

Less common is stuttering, neurotic tics, blinking tics, whimpering, tongue-tied. All of these symptoms arise (or are exacerbated) in the presence of persons to whom the hysterical reaction is directed.

A more frequent symptom is enuresis (bedwetting), more often due to changes in the environment (a new kindergarten, school, home, the appearance of a second child in the family). Temporary withdrawal of a baby from a traumatic environment can lead to a decrease in diuresis attacks.

Diagnosis of the disease

The diagnosis can be made by a neurologist or psychiatrist after the necessary examination, during which there is an increase in tendon reflexes, tremor of the fingers. During the examination, patients often behave unbalanced, may groan, scream, demonstrate an increase in motor reflexes, spontaneously shudder, cry.

One of the methods for diagnosing hysterical seizures is color diagnostics. The method is a rejection of a certain color during the development of a particular condition.

For example, an orange color is unpleasant for a person, this may indicate low self-esteem, problems with socialization and communication. Such people usually do not like to appear in crowded places, it is difficult for them to find a common language with others, make new friends. Rejection of the blue color and its shades indicates excessive anxiety, irritability, agitation. Dislike for the red color indicates violations in the sexual sphere or psychological discomfort that arose against this background. Color diagnostics is currently not very common in medical institutions, but the technique is accurate and in demand.

First aid

Quite often it is difficult to understand whether the sick person in front of you or the actor. But despite this, it is worth knowing the mandatory first aid recommendations in this situation.



Do not persuade a person to calm down, do not feel sorry for him, do not become like a patient and do not panic yourself, this will only incite the hysteroid even more. Be indifferent, in some cases you can go to another room or room. If the symptoms are stormy and the patient does not want to calm down, try to splash cold water in his face, bring ammonia vapor to inhale, give a slight slap in the face, press on the pain point in the cubital fossa. In no case do not indulge the patient, if possible remove strangers or take the patient to another room. After that, call the attending physician, do not leave the person alone until the arrival of the medical worker. After an attack, give the patient a glass of cold water.

Do not hold during an attack of the patient by the arms, head, neck or leave him unattended.

To prevent seizures, you can drink courses of tincture of valerian, motherwort, use sleeping pills. The patient's attention should not be fixed on his disease and its symptoms.

Hysterical seizures appear for the first time in childhood or adolescence. With age, the clinical manifestations are smoothed out, but in the menopause they can again remind themselves and become aggravated. But under systematic observation and treatment, exacerbations pass, patients begin to feel much better without seeking help from a doctor for years. The prognosis of the disease is favorable when the disease is detected and treated in childhood or adolescence. It should not be forgotten that hysterical seizures may not always be a disease, but represent only a personality warehouse. Therefore, it is always worth consulting with a specialist.

Providing first aid for strokes, epileptic and hysterical seizures

Stroke- acute circulatory disorders in the brain and spinal cord as a result of hypertension and atherosclerosis of cerebral vessels. The disease occurs suddenly, often without any precursors, both during wakefulness and during sleep. The patient loses consciousness, vomiting, involuntary separation of urine and feces occur.

The face is hyperemic, with cyanosis of the nose and ears. Breathing is disturbed, frequent, wheezing, replaced by rare single breaths or its cessation. The pulse slows down to 40-50 per minute. Paralysis of the limbs, asymmetry of the face (paralysis of the mimic muscles of half of the face) and anisocoria (uneven pupil width) are often detected. Sometimes a stroke is less violent, but is always accompanied by paralysis of the limbs and impaired speech.

The patient must be laid on the bed and unbuttoned clothes, give a sufficient supply of fresh air. The head should be overlaid with ice packs, put heating pads at the feet. Absolute rest is needed. If swallowing is preserved, sedatives are given (valerian tincture, bromides), drugs that lower blood pressure (dibazole, papaverine).

It is necessary to monitor breathing, prevent retraction of the tongue, remove mucus and vomit from the oral cavity. It is possible to move and transport to the hospital only after the conclusion of the doctor about the transportability of the patient.

epileptic seizure- one of the manifestations of mental illness - epilepsy. During a seizure, there is a sudden loss of consciousness with tonic and then clonic convulsions, a sharp turn of the head to the side and the release of foamy fluid from the mouth.

In the first seconds of an attack, the patient falls, often getting injured. There is a pronounced cyanosis of the face, the pupils do not react to light. During a seizure, involuntary urination and defecation occur.

The duration of the seizure is 1-3 minutes. After the cessation of convulsions, the patient falls asleep and does not remember what happened to him.

When providing first aid, do not hold the patient at the time of convulsions and transfer to another place. Something soft is placed under the head, clothes are unbuttoned, a folded handkerchief should be put between the teeth to prevent biting the tongue. After the cessation of seizures, it is necessary to transport the patient home or to a medical institution.

An epileptic seizure and stroke must be distinguished from a hysterical seizure.

hysterical fit

A hysterical attack usually develops in the daytime, it is preceded by a stormy, unpleasant experience for the patient. A patient with hysteria falls gradually in a convenient place, without bruising, the observed convulsions are erratic, spectacularly expressive.

There is no frothy discharge from the mouth, consciousness is preserved, breathing is not disturbed, the pupils react to light. The duration of the seizure depends on the reaction of others: it is the longer, the more attention is paid to the patient. Involuntary urination, as a rule, does not happen.

After the cessation of convulsions, the patient continues his activity, does not fall asleep, there is no stupor.

When providing first aid, the patient should not be restrained; it is necessary to move to a quiet place and remove strangers, give a sniff of ammonia. In such conditions, the patient quickly calms down and the attack passes.

First aid in public places. Reference

angina pectoris

A symptom of heart disease, not the disease itself. These are pressing pains that appear in the heart muscle when it tries to do its job without getting enough blood, which means oxygen and glucose.

Symptoms:
- Constrictive pain in the center of the chest;
– Spread of pain to the left or both arms, along the back or up the neck;
- Seizures are associated with physical effort;
– Shortness of breath may occur;
– There may be pale skin and blue lips.
Help with an attack of angina pectoris:

Help the patient to sit down and take the most comfortable position. Give him some rolled up clothes.

Ask if he has a heart medicine (nitroglycerin). If available and in the form of pills, the medicine should be put under the tongue (only if the patient is conscious). If available as an aerosol, it should be sprayed under the tongue.

Loosen tight clothing and make breathing easier for the patient. Calm him down.

See if the pain is gone after one or two minutes of rest. If the pain persists, it is not angina, but a heart attack. Urgent hospitalization of the patient is vital and can save his life.

Heart attack

Symptoms:
- Sudden attack of sharp pain in the middle of the chest or behind the sternum;
– The pain may radiate to the arms, back, or throat;
- The patient's confidence that he is dying;
- Dizziness and fainting;
- Profuse sweat;
– Paleness;
- Weak, rapid pulse. May be intermittent (normal pulse is 60-80 beats per minute);
- Lack of air;
– Sometimes loss of consciousness;
- Occasional cardiac arrest.

Help with a heart attack

If the patient is conscious, move him to a reclining position. Place pillows (rolled clothes) under your head, shoulders, and knees. Loosen tight clothing at the neck, chest and waist.

Reassure the patient and help him relax.

Call for help and have someone call an ambulance and say that the patient is having a heart attack.

Check pulse and respiration. If the victim loses consciousness, lay him on his side and regularly check his breathing and pulse.

If breathing has stopped, give mouth-to-mouth artificial respiration. The mechanism of artificial respiration is as follows:
– Place the victim on a horizontal surface.
- Clean the mouth and throat of the victim from saliva, mucus, earth and other foreign objects, if the jaws are tightly clenched, move them apart.
- Tilt the victim's head back, placing one hand on the forehead and the other on the back of the head.
- Take a deep breath, bending over the victim, seal the area of ​​\u200b\u200bhis mouth with your lips and exhale. The exhalation should last about 1 second and help lift the victim's chest. In this case, the nostrils of the victim should be closed, and the mouth is covered with gauze or a handkerchief for reasons of hygiene.
- The frequency of artificial respiration - 16-18 times per minute.
- Periodically release the stomach of the victim from the air, pressing on the epigastric region.

In case of cardiac arrest, start chest compressions.

The mechanism of external heart massage is as follows: with a sharp jerky pressure on the chest, it shifts by 3-5 cm, this is facilitated by muscle relaxation in the victim, who is in a state of agony. This movement leads to compression of the heart, and it can begin to perform its pumping function - it pushes blood into the aorta and pulmonary artery when squeezed, and when straightened, it sucks in venous blood.

When conducting an external heart massage, the victim is laid on his back, on a flat and hard surface (floor, table, ground, etc.), the belt and collar of clothing are unfastened. The assisting person, standing on the left side, puts the palm of the hand on the lower third of the sternum, puts the second palm crosswise on top and produces a strong dosed pressure towards the spine.

The correct position of the hands: the thumb is directed to the head (to the legs) of the victim. Pressure is produced in the form of pushes, at least 60 per minute.

When conducting a massage in an adult, a significant effort is required not only of the hands, but of the entire body of the body. In children, massage is performed with one hand, and in infants and newborns - with the tips of the index and middle fingers, with a frequency of 100-110 shocks per minute. The displacement of the sternum in children should be within 1.5–2 cm.

The effectiveness of indirect heart massage is provided only in combination with artificial respiration. They are more convenient for two people. In this case, the first makes one blowing of air into the lungs, then the second makes five pressures on the chest. If the victim's cardiac activity is restored, the pulse is determined, the face turns pink, then the heart massage is stopped, and artificial respiration is continued at the same rhythm until spontaneous breathing is restored. The question of termination of measures to provide assistance to the victim is decided by the doctor called to the scene.

Sudden cardiac arrest

Symptoms:
- The person falls, loses consciousness and lies motionless;
- There are no respiratory movements;
- The pulse is not felt anywhere;
- The skin turns gray.

In case of cardiac arrest:

Scream, call for help. Have someone call, call an ambulance and say that the patient is in cardiac arrest.

Perform two breaths from mouth to mouth. Proceed to external cardiac massage. Every 15 compressions, take two breaths. This should be done before the ambulance arrives.

Fainting

Symptoms:
– Paleness;
– Sweating;
- Dizziness;
– Deterioration of vision;
– ringing in the ears;
- Loss of consciousness;
- A fall.

Fainting is accompanied by blanching and cooling of the skin. Breathing is slow, shallow, weak and rare pulse (up to 40-50 beats per minute).

First aid for fainting:

It is necessary to lay the victim on his back so that his head is slightly lowered and his legs are raised.

To facilitate breathing, release the neck and chest from tight clothing.

Rub ammonia on the patient's temples and bring a cotton swab moistened with ammonia to the nose, and spray your face with cold water.

With prolonged fainting, artificial respiration is indicated.

epileptic seizure

Sudden loss of consciousness with a characteristic scream before falling. The head is thrown back, the arms are bent, the fingers are clenched into fists, the legs are extended. The chest freezes in the position of maximum exhalation. Then spasms, involuntary movements begin. Foam is released from the mouth, sometimes with an admixture of blood; involuntary urination, defecation occur. This continues for up to two minutes. After that, the patient calms down. His consciousness is absent, the muscles are relaxed, there are automatic movements. Breathing from convulsive becomes quiet, calm. There comes a deep sleep, after half an hour is replaced by a superficial, light, lasting up to several hours. After the attack - short-term memory loss.

First aid for an epileptic seizure

Help should be, first of all, in the prevention of injury to the patient. If you managed to notice the harbingers of a seizure, support the patient so that he does not fall on his back, move him as far as possible from furniture, glasses and sharp objects. Try to smoothly lower it to the floor, placing any soft object under your head (jacket, slippers, bag), turn it on its side. Press your shoulders and head to the floor. At the next stage, one should try to unclench the patient's teeth and insert some solid object wrapped in cloth between them (from the side). This will prevent biting your tongue. Be sure to call an ambulance. Until the arrival of the doctor, do not let the patient go, monitor his condition. After the end of the seizure, when the patient falls asleep, in no case wake him up, he should wake up on his own.

Airway blockage:

Airway obstruction usually occurs when a foreign body, such as an unchewed piece of food or a hard piece of candy, enters the windpipe when inhaled.

Symptoms:
- A person grabs his throat with his hand;
- Shows clear signs of panic fear and confusion;
– Cannot speak;
- Breath escapes first with a whistle, and then stops altogether;
- Turns blue or sometimes turns pale;
“He loses consciousness in about a minute.

First aid for obstruction of the airways:

Conscious adult: The victim should bend forward so that his head is below the waist. Tap him sharply between the shoulder blades with the base of your palm.

Awakened child: Lay him on your knees, face down, and tap the base of your palm between your shoulder blades.

If an adult or child is unconscious:

Turn the victim on their side to face you. Tilt back his head. If necessary, tap him four times on the back with the base of your hand.

Infants and young children:

Lay your baby face down on your arm. Support his head and chest with your palm.

Gently tap the baby four times with your fingers between the shoulder blades. If that doesn't help, use the abdominal pressing method.

hysterical fit

Symptoms (lasts several minutes or hours): consciousness remains; there is no sudden fall; excessive excitement in behavior and speech; cries and sobs - especially in the crowd; sometimes - arching of the whole body with support on the back of the head and heels ("hysterical arc").

Hysterical psychopaths strive to attract attention to themselves, they are distinguished by defiantly strange clothes and "demonstrative" behavior.