Sopor: what is it?

Clear consciousness during wakefulness is one of the indicators of the normal functioning of the brain. Various pathological conditions can lead to a decrease in the depth of consciousness until it turns off. It is very important that in this case the consciousness does not change qualitatively, but only oppresses. One of such quantitative disorders of consciousness is sopor. The appearance of such a disorder requires the establishment of its exact cause and the elimination of factors that adversely affect the functioning of the brain.

Why there is a squirt

Sopor is a sign of dysfunction of the cerebral cortex and the predominance of the inhibitory effect of the reticular formation. It can occur with a variety of damages to the nervous tissue, severe hypoxia of the brain or the action of a number of substances that can be produced in the body itself or come from outside.

Basic conditions that can be accompanied by a comparison:

• ONMI (acute cerebrovascular accident) in the form of ischemic or hemorrhagic stroke, especially if they seize the upper parts of the brainstem;
• severe hypertensive crisis;
• head trauma, leading to damage to the nerve tissue and / or hematomas of different locations;
• expressed deviations in the level of glucose and / or products of carbohydrate metabolism in diabetes mellitus;
• hypothyroidism;
• volumetric formations (most often tumors), causing swelling and edema of the brain or displacement of its structures;
• pronounced metabolic disturbances in hepatic and renal insufficiency;
• Subarachnoid hemorrhage with aneurysm rupture;
• brain damage due to the action of carbon monoxide or certain substances (methyl and ethyl alcohols, barbiturates, opioids and any drugs in a high toxic dosage);
• Infectious-inflammatory diseases of the central nervous system, leading to the development of meningitis and meningoencephalitis;
• sepsis;
• pronounced disturbances of electrolyte and water exchange;
• severe heart failure (for example, after myocardial infarction, with a marked violation of the heart rhythm, etc.);
• heat stroke or hypothermia.

The clinical picture of sopor does not depend on its cause, the symptoms of the underlying disease are supplemented with signs of depression of consciousness.

Symptoms of a co-morbid state

The person in the sock looks like a sleeper, the reaction is caused only by strong stimuli. With a sharp sound, his eyes open, but the targeted search movements do not arise. After pressing on the nail bed, the limb is withdrawn. And an injection, pat on the cheek or other painful effect causes a rather bright but short-term negative reaction in a person in comparison. Sometimes the patient fights and quarrels.

On examination, attention is drawn to the overall decrease in muscle tone, suppression of deep reflexes. Pyramid marks are often found because of the decrease in the influence of central motoneurons. The reaction of the pupils to light is weak, the corneal reflex and swallowing are preserved.

Along with this, focal neurological symptoms can be detected, indicating local damage to certain structures and areas in the brain. If the sopor is caused by intracranial hemorrhage or meningoencephalitis, stiff neck and other meningeal symptoms will be detected. Also, convulsive seizures, muscle twitching in the form of myoclonias, and non-targeted ones may appear.

Sometimes there is a hyperkinetic version of the sopor, when a person incoherently mumbles, offends, commits certain non-purposeful movements, productive contact with him is impossible. This condition resembles a depressing delirium, which refers to qualitative disorders of consciousness.

Survey in Sore

The doctor conducts an objective examination, determines the depth of the disturbance of consciousness and identifies the possible causes of this condition.

With violations of consciousness, it is necessary to determine the level of its oppression, differentiating the sopor from coma and stunning. The main examinations are aimed at identifying the cause of the disruption of the brain and the associated metabolic shifts.

The doctor needs to get the most possible information about what preceded the oppression of consciousness. To do this, the medical documentation is examined, a survey of accompanying persons and relatives is conducted. The clothes and personal belongings of the patient are also inspected, which sometimes makes it possible to detect the packages of the drugs used, individual cards with information about the existing diseases.
When detecting a spore, a number of screening studies should be carried out quickly:

• Examination of the patient's body to detect damage, rash, hemorrhages, traces from injections, detecting the smell of alcohol;
• measurement of blood pressure;
• measurement of body temperature;
• determining the level of glucose in the blood;
• ECG and auscultation (listening) of the heart.

Simultaneously, tests are taken to determine the blood picture, the main biochemical indicators and the level of electrolytes. If a poisoning is suspected, the blood is taken for toxicology and urine for screening for the main narcotic substances. In some cases, the neurologist makes a decision about emergency lumbar puncture and MRI (CT) of the brain.

Principles of treatment of sopor

Sopor - this is not an independent disease, but evidence of a disruption of the brain. Therefore, treatment should be aimed at eliminating the cause of oppression of consciousness, and it should begin as soon as possible.

In the development of sopor, an important role is played by ischemia and edema of the brain tissue, which can occur in a variety of conditions. Earlier treatment will help prevent brain wedging into the natural openings of the skull and preserve the viability of neurons. Especially vulnerable are the nerve cells in the so-called penumbra zone (or ischemic penumbra) - the area immediately adjacent to the lesion focus in the brain. With inadequate therapy, there will be an increase in symptoms due to the death of neurons in this zone. In this case, the sopor can pass into a coma, and neurological disorders will be persistent and pronounced.

In the treatment of sopor, the main actions are aimed at eliminating the edema of the nervous tissue, maintaining adequate blood supply to the brain. Also, the blood glucose level is corrected and the micronutrient deficiency is corrected, cardiac arrhythmias are eliminated and renal and hepatic insufficiency is treated. When infections are prescribed antibacterial agents, and the presence of hemorrhages requires measures to stop bleeding.

The prognosis of the co-infection depends on its cause, the depth and nature of the lesion of the nervous tissue and the volume of the therapeutic measures carried out. The earlier the etiology is revealed and the gross disorders are corrected, the higher the chance for a quick recovery of clear consciousness and regression of the symptoms of the underlying disease.