Empty feeling

Introduction The emptiness is also known as the catching of the bed. Inspection method: When examining the patient, see the upper limb in a purposeless groping movement. At this time, the patient is accompanied by mild disturbance of consciousness, loss of orientation, accompanied by irritability, nonsense, and many words without any reason.

Cause

The empty sign is more common in severe illnesses such as typhoid fever, typhus, epidemic encephalitis, severe pneumonia, hepatic coma and other toxemias, drunkenness, and excessive sedatives and atropine poisoning. Generally speaking, this sign is a signal of critical illness, indicating inhibition of the cerebral cortex and subcortical network structure.

an examination

Related inspection

Lung ventilation imaging, brain CT examination, pulmonary function test, brain MRI examination

The emptiness manifests itself as an unconscious groping action in which the upper limbs are mainly elbows, wrists, and hand joints.

1 emptiness with dysfunction, high fever, seen in menstruitis, typhoid and sepsis in the high fever period.

2 In the past, there was a history of chronic liver disease, and there was a disturbance of consciousness and emptiness. Hepatic coma should be considered.

Differential diagnosis

Differential diagnosis of emptiness:

Tremor

Tremor is a limb swinging motion caused by alternating contraction of antagonistic muscles in two groups. Its accompanying symptoms and common causes are as follows:

(1) Resting tremor: It is obvious when it is still, more common in the hands and fingers, and it is in the form of pills. When the fatigue, emotional stress and anxiety are aggravated, the tremor is aggravated, the activity is relieved, the sleep disappears, and the muscles are strong, which is more common in Parkinson's Disease (tremor numbness). (2) Symptoms of senile tremor are similar to those of tremor palsy, often characterized by nodding or shaking their heads. Generally not accompanied by changes in muscle tone. Common in elderly patients with arteriosclerosis.

(3) Action tremor: tremor occurs during the action, at the end of the movement, the closer to the target, the more obvious, more common in cerebellar diseases.

(4) flapping tremor: this tremor is a slight deviation of the finger to the outside, and the palm joint and wrist joint are irregularly 6 to 9 times per second, and the speed is small, like the bird's wing-like flexion and extension movement, if In the past, he had a history of chronic hepatitis and cirrhosis, and he was alert to hepatic coma in the early stage of hepatic encephalopathy. Finger tremors, polyphagia, weight loss, irritability, palpitations, excessive sweating should consider hyperthyroidism.

2. Dance-like movement

Small dance disease: also known as rheumatoid dance disease. More subacute onset, or unconsciously ill. More common in adolescents and women, can be induced by mental stress and overwork. Expressed as a fast, involuntary, irregular, non-repetitive and purposeless dance-like action. Such as eyebrows, mouth, mouth, mouth, nose, neck, shoulders, waist, neck, abdomen, arm, palms and knees. Most caused by rheumatism.

3. Hand and foot movement

A slow and continuous stretching and twisting action of the fingers or toes can be repeated and more regular.

1 cerebral thrombosis: more than a history of arteriosclerosis, hypertension, diabetes. More consciousness, dizziness, dizziness, involuntary movement of the lesion side, mild hemiplegia and sensory disturbance on the contralateral side are more common in cerebral thrombosis.

2 There is a history of infections such as colds and diarrhea within one month before the onset of illness. Pre-existing symptoms of patients before onset include headache, burnout, nausea, vomiting, sleep disorders, and decreased mental activity. Hand movements, fever, disturbance of consciousness, should consider the brain basal ganglia degeneration caused by encephalitis.

3 hands and feet, tremors, faint expression, skin yellowing, hepatomegaly, abdominal pain, nausea, vomiting, bloating, indigestion, anorexia, diarrhea, corneal edge and sclera junction often green brown or golden brown pigment ring, should Consider hepatolenticular degeneration.

4. Hand and foot convulsions

In the onset of hand and foot convulsions, the muscles of the hands and feet are tense, and the upper limbs are characterized by wrist flexion, finger extension, and flexion of the palmar joint. The thumb is close to the palm and the little finger. In the lower limbs, the ankle joint and the toe joint are both flexed. Found in hypocalcemia and alkalosis. The emptiness manifests itself as an unconscious groping action in which the upper limbs are mainly elbows, wrists, and hand joints.

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