Fantasies of losing sense of time and space

Introduction Fantasy loss of time and space is more common in opioid poisoning. Such drugs include opioids, morphine, codeine, compound camphorquinone and papaverine, represented by morphine (opium contains 10% morphine). Most of morphine is metabolized in the liver and is excreted in the kidney within 24 hours. After 48 hours, there is only a trace amount in the urine. The effect of morphine on the central nervous system is first excitatory, post-inhibition, and mainly inhibition. First, it inhibits the high-level center of the cerebral cortex, which in turn affects the brain, inhibits the respiratory center and excites the chemosensory area.

Cause

A large number of misuses or frequent use of opioids can cause poisoning. The morphine poisoning rate was 0.06 g in adults and the lethal dose was 0.25 g; the codeine toxicity was 1/4 of morphine, the toxic dose was 0.2 g, and the lethal dose was 0.8 g. Patients with chronic diseases such as liver disease, emphysema, bronchial asthma, anemia, thyroid or chronic adrenal insufficiency are more likely to develop poisoning. With alcoholic drinks, even if the dose is treated, there is a possibility of poisoning. Barbiturates and other hypnotic drugs have synergistic effects with this class of drugs, and should be used with caution.

an examination

Related inspection

Brain MRI examination of brain CT examination of brain ultrasound

1. There is a history of applying excessive opioids.

2. Clinical manifestations: Mild poisoning is headache, dizziness, nausea, vomiting, excitement or inhibition. In severe poisoning, coma, dilated pupils such as needle tip size and difficulty breathing. Chronic poisoning is mainly characterized by loss of appetite, constipation, weight loss, aging and sexual dysfunction.

3. Urine and stomach contents are detected in the presence of opioids.

Differential diagnosis

Dream illusion: In some states, including dreaming, fantasy and self are separated, and people do not realize that they are fantasizing. "Fantasy" is an illusion that the information is taken out of the sensory memory and then sent back to the sensory area. The purpose of the dream illusion is to replace the real signal with a simulated sensory signal, driving the autonomic nervous system to perform the psychosomatic role. The patient has a dreamy feeling, like a strange feeling in a dream, often accompanied by a illusion. A feeling, due to the lack of corresponding realistic stimuli, the objective test results prove that this feeling is illusory, but in terms of the patient's own experience, it does not feel illusory. Some patients believe that their feelings come from objective reality.

Victims of murder: The patients lack of security leads to an extreme distrust of the outside world and an illusion. More often than the elderly or some people who have been hit by a range beyond self-sustainability. The patient will be convinced that someone (or a group) will monitor, attack or persecute themselves, their loved ones, and their families. These persecution activities include conspiracy, stalking, and poisoning in food. Under the circumstance, the patient refused to eat, escape, and accused, causing self-injury or injury. Such patients are usually very nervous. More common in schizophrenia, paranoid mental illness.

Alcoholic hallucinations: Alcoholic disorders, consisting of more or less simple auditory hallucinations, are a special type. Kraepelin calls it alcoholic hallucinations or alcoholic mental mania. The core manifestation is: although the patient feels normal, such as patient orientation, normal responsiveness, and good memory, there is auditory hallucination. The nature of auditory hallucinations can be unstructured sounds, such as bee squeaking, ringing, gunbing or knocking, or musical, low-pitched singing or chatting. But the most common sound is the human voice. The sound can talk directly to the patient, but it is more common to talk to a third person about the patient. In most cases, the voice is malicious, blaming or intimidating, seriously disrupting the normal life of the patient. For the patient, the sound is extremely real. Another characteristic of auditory hallucinations (and visual hallucinations) is that patients respond to the production of hallucinations. The patient may be able to protect himself or have an anti-invasion behavior, and may even attempt to commit suicide to escape the intimidation of the voice. They may vary in duration, may be temporary, or may be recurring intermittently within a few days, and in individual cases may last for weeks or months.

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