Catatonic stupor

Introduction A manifestation of mental illness. One of the special manifestations of psychomotor inhibition. The degree of clinical difference is different. The active speech and activities of the lighter are obviously reduced or slow, with stereotypes, called sub-woody state; the severe muscles of the whole body are almost completely disappeared, and can sit, stand or lie. No movement, no expression, no answer, no push, no food, no drooling, lasting days, months, a few sustainable years, can suddenly ease or turn into tension, excitement, see the spirit Schizophrenia is tense.

Cause

None of the laboratory and psychological tests have reached a level of specificity that can certainly assist in the diagnosis. Around the study of etiology, domestic and foreign scholars have accumulated a lot of reference materials. From the analysis of existing data, this disease is a disease with genetic basis, and the biological, psychosocial and environmental factors in the external environment can have certain influence on the onset. Some patients have changes in brain structure and occurrence.

an examination

Related inspection

Neurological examination, electroencephalography, cranial nerve examination

The patient is silent, immobile, violated, or passively obedient, accompanied by increased muscle tone. The patient's posture is extremely unnatural, such as the patient lying on the bed, the distance between the head and the pillow (air pillow), and the day and night standing still. It can be seen that any part of the patient with a waxy flexion can be freely placed and held in a fixed position. Sometimes impulsive behavior can occur suddenly, that is, nervous excitement: the patient's behavior is impulsive, the action is cluttered, the work is pretentious or stereotyped.

Differential diagnosis

(1) Schizophrenia catatonic type Most of the onset of illness in young or middle-aged patients is more urgent. The course of the disease is mostly paroxysmal. Mainly manifested as nervous excitement and nervous stiffness. The two appear alternately or separately. The former expresses impulsive behavior, is incomprehensible, and the verbal content is monotonous, the movements are weird, and the words are imitated. The latter manifests in the inhibition of exercise, less speech, less movement, no response, no reaction to the surrounding environment, violation of the imitation, imitating movements and imitating speech, even with illusion delusions.

(B) Depression (depression) In the woody depression, the patient is silent, no self-motivated, not even eating, defecation, and can be transferred from acute depression.

(3) Myxedma The basic symptom is that all activities of the patient are slow, accompanied by memory loss, illusion and hallucinations, and some patients may exhibit a stupor state.

(D) lead poisoning (lead poisoning) In severe poisoning, lead poisoning encephalopathy occurs. Expressed mentally retarded, slow-moving, depressed or excited. Further development is manic, stunned, horrified, stiff or comatose. According to the history of lead exposure and clinical manifestations, it is not difficult to diagnose the disease.

(5) Mental disorders caused by brain injury In the brain contusion and laceration, the patient's expression consciousness is narrowed, the perception is blurred, the orientation is limited, and the patient may suddenly have excitement, impulsivity, attack, As a result of disciplinary behavior. There can be some meaningless actions. There are also rich and vivid illusions and hallucinations. It can also be accompanied by other symptoms, which can be diagnosed according to the history of trauma.

(6) Reactive mental disorders Acute onset of illness under intense trauma, the patient suddenly stagnates, silent, and calls should not. It lasts for a short time, most of which lasts for a few minutes or hours, and occasionally for a few days, but generally no more than a week. Individual patients can be transferred to an excited state when the stupor state is relieved, and most of them are accompanied by disturbance of consciousness. This type of stupor is called reactive stupor, also known as psychogenic stupor. In the treatment of schizophrenia, psychotropic medication is a key treatment. Supportive psychotherapy and improvement of the psychosocial environment and improvement of the patient's state of mind are also of great significance, generally in combination with drug treatment when the patient's condition improves. In the remission or chronic phase, in addition to appropriate medications, environmental, psychological treatment and social support are necessary, especially for the social rehabilitation of patients, prevention of patient decline, and improving the ability of patients to adapt to society. Safe care in the acute phase and home monitoring in the chronic phase or during rehabilitation are also necessary.

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