A disorder of consciousness refers to any deviation from ordinary everyday or normal consciousness and is often mistakenly seen as a disease in its own right. However, it is a symptom that can have various physical or psychological causes.
What are disorders of consciousness?
Disorders of consciousness can be manifested by various symptoms and are generally divided into two different forms: qualitative and quantitative disorders of consciousness. Two different types of disorder of consciousness are distinguished. On the one hand, there is the qualitative disorder of consciousness, which occurs as a twilight state or confusion, usually as a result of psychiatric diseases, and the quantitative. Consciousness disorders can be manifested by various symptoms and are generally divided into two different forms: qualitative and quantitative consciousness disorder. Such a disorder is referred to as qualitative when symptoms such as a short-term or a permanent clouding of consciousness occur or when there is a fixation by thoughts and emotions on an experience so that the affected person is limited in his or her responsiveness. Shifts or expansions of consciousness are also part of this form. Quantitative disorders of consciousness refer to the level of wakefulness and are divided into different degrees of severity. Symptoms of quantitative disorder of consciousness range from drowsiness to increased sleepiness to coma. This is a disorder of vigilance (wakefulness). This can manifest itself in different ways. On the one hand as drowsiness (slowed thinking, acting, difficult orientation) as well as somnolence (drowsiness, from which the patient can be awakened by external stimuli) or as sopor (patient can only be awakened with great difficulty), and as coma (patient can no longer be awakened) or delir (impaired consciousness and orientation, as well as hallucinations). In some cases, retrospective amnesia also occurs. This is a partial or complete loss of memory. Sometimes only long-term or short-term memory is affected, and memories return after some time.
Causes
What are the causes of disorders of consciousness? A disorder of consciousness can have different causes. There are various psychiatric disorders, such as schizophrenic psychosis, in which a patient suppresses his or her own self and takes on the role of another person. The trigger for this can be years of abuse in childhood. The causes of disorders of consciousness are varied and in many cases cannot be clearly determined. Again, of course, a distinction is made between the two types of the disorder. Quantitative disorders of consciousness can be due, for example, to increased intracranial pressure but also to concussions or to traumatic brain injury. However, there are also physical diseases that can lead to a disorder of consciousness. Even after a stroke, in which the brain can no longer be supplied with sufficient oxygen due to a vascular occlusion, clouding or constriction of consciousness can occur. Another cause can be the blood sugar level, if it falls below 70 or exceeds 400. In general, respiratory and circulatory disorders, as well as inflammation of the nervous system, can also lead to disorders of consciousness. The causes of qualitative disorders of consciousness are similar. Both inflammation of the brain and traumatic brain injury can be listed as causes. Mental disorders and diseases can also affect consciousness. For example, people with traumatic experiences, dissociative disorders or psychosis often show symptoms that indicate a disorder of consciousness. Medications, drugs or alcohol have a depressant effect and can therefore cause symptoms in excessive amounts. But also metabolic diseases, such as diabetes mellitus or poisoning, are often responsible for disorders of consciousness. A disturbance of consciousness or even a clouding is always a warning signal of the body and should be immediately examined by a doctor.
Diseases with this symptom
- Diabetes mellitus
- Meningitis
- Epilepsy
- Spotted fever
- Hypotension
- Encephalitis
- Sunstroke
- Food poisoning
- Anxiety disorder
- Mushroom poisoning
- Concussion
- Early summer meningoencephalitis
- Sunstroke
- Heat stroke
- Stroke
Complications
The severity of complications associated with a disorder of consciousness depends in no small part on the cause that led to the disorder of consciousness. Without further intervention, the affected person’s condition may improve or worsen. In the worst case, the affected persons are no longer able to cope with everyday life by themselves. Causes that may be responsible for various complications include:
- The stroke
- Cranial injuries
- Poisoning from medications, food, alcohol, drugs, sunstroke, and more.
- A general anesthesia (often associated with other complications).
Hypoglycemia (low blood sugar) with impaired consciousness occurs not infrequently in type 1 diabetics when insulin is forgotten or incorrectly dosed. The risk increases the lower the average blood glucose level. A particularly severe complication of impaired consciousness is “delirium,” which is a psychiatric emergency. In the worst cases, it can lead to coma. Anxiety and panic disorders, as well as acute suicide risk, are more common. Somnolence and sopor may also occur. Immediate inpatient treatment is required, otherwise further complications such as respiratory arrest, heart failure or metabolic disorders may develop. Late effects may include cognitive impairment, which can be a considerable hindrance in everyday life for those affected. In addition, cerebral seizures have also been known to occur as a result of impaired consciousness, as well as respiratory arrest and hypoglycemia with risk of shock.
When should you see a doctor?
If there is a disturbance of consciousness, a physician should be consulted immediately. In most cases, the disturbance is based on another disease that must be found and clarified. Some of the underlying disorders may be considered life-threatening. Therefore, a doctor should be consulted immediately in case of repeated disturbances of consciousness. Impairment of consciousness is usually due to dysfunctions of individual brain areas. These can suffer lesions during falls, accidents or inflammations. Hemorrhages or swellings of tissue in the brain are usually insidious processes that are accompanied by impaired consciousness as a symptom. Often, the triggering event occurred several days ago and thus is not necessarily associated with the current disturbances of consciousness. For this reason, disorders of consciousness are in many cases to be regarded as serious warning signals and require a rapid response. This is also the case if the disturbances occur only for a short time. Hemorrhages in the brain can lead to a stroke. Since this can be fatal or cause lifelong impairments, those affected should undergo a thorough examination. In addition, dysfunctions of individual organs can lead to impaired consciousness. Once one system in the organism is impaired, other organs are subjected to greater stress. It can lead to further partial or even total failure of the organs. This is often associated in advance with symptoms such as impaired consciousness.
Treatment and therapy
How can disorders of consciousness be treated? The treatment of disorders of consciousness naturally depend on the causes responsible for the disorder, so a comprehensive diagnosis is essential. Especially at the onset of severe disorders of consciousness, the patient should be permanently under observation and receive medical care. The basic goal of treatment should be to stabilize consciousness. Physiotherapists can provide additional support to the affected person by performing exercises to stimulate the circulation, among other things. Triggers such as a stroke should generally be treated in a rehabilitation clinic. In some cases, medications that act on consciousness and help stabilize it are also used for milder disorders of consciousness. People who suffer from a disorder of consciousness due to mental illness can also find help in psychotherapy, in addition to appropriate medication.
Outlook and prognosis
The prognosis for disorders of consciousness depends very much on the particular disorders themselves.In the case of disorders of consciousness, there is usually a strong social exclusion. Often the affected person complains of anxiety and feelings of insecurity, as well as depression. Here, treatment with a psychiatrist is highly recommended. Treatment by a psychologist or psychiatrist can lead to success if the affected person is aware of the disorders of consciousness and also wants to do something about them. In many cases, the treatment is also carried out in parallel with medication, which causes headaches and fatigue. Without treatment, the disorders of consciousness usually do not disappear on their own. It is a psychological problem. So it can also happen that certain things are done, which the patient cannot remember at all and which were not intended. Often people with disorders of consciousness experience very slow thinking and only a limited ability to absorb information. The highest case of disorders of consciousness is coma. In this case, no direct treatment is possible. It is necessary to wait and see if and when the person will come out of the coma.
Prevention
How can disorders of consciousness be prevented? Because there are so many different causes, it is almost impossible to completely prevent a disorder of consciousness. Nevertheless, certain precautions can be taken to reduce the risk. For example, a stroke often develops from a poor lifestyle. Sufficient exercise, a healthy diet and regular relaxation phases can help prevent this diagnosis from occurring in the first place. The use of medications and alcohol should also be responsible, so that excessive use or intoxication is avoided. Since disorders of consciousness should be treated as soon as possible, one should take one’s symptoms seriously and seek medical attention immediately if suspected.
This is what you can do yourself
Whether self-help remedies are really effective for disorders of consciousness depends very much on the level of the disorders of consciousness. If they occur only rarely and are not particularly severe, the affected person can do something about them himself. In most cases, the disorders of consciousness are caused by the consumption of certain medications or drugs. In order for these disturbances to disappear, the respective drug must be discontinued. A doctor or, in an emergency, withdrawal can help here. The patient himself must actively do something about the disorders of consciousness. This includes learning tasks and thinking tasks so that the brain can develop its full function again. In some cases, the disorders of consciousness can occur due to stress and lack of sleep. In this case, the body needs rest and recovery. For more severe disorders of consciousness, home remedies usually do not help and a doctor must be consulted. In the case of dementia or Alzheimer’s disease, there is no direct treatment; in this case, the patient is dependent on the help of others or caregivers to cope with everyday life. If the disorders of consciousness occur due to psychological problems, psychological treatment can help. In the most severe form of impaired consciousness – coma, no means of treatment are available. This condition is largely unexplored and cannot be directly influenced.
