A state of reduced sensibility and response to stimuli which is distinguished from COMA in that the person can be aroused by vigorous and repeated stimulation. The person is still conscious and can make voluntary movements. It can be induced by CENTRAL NERVOUS SYSTEM AGENTS. The word derives from Latin stupere and is related to stunned, stupid, dazed or LETHARGY.
A profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem RETICULAR FORMATION.
Organic mental disorders in which there is impairment of the ability to maintain awareness of self and environment and to respond to environmental stimuli. Dysfunction of the cerebral hemispheres or brain stem RETICULAR FORMATION may result in this condition.
An 86-amino acid polypeptide, found in central and peripheral tissues, that displaces diazepam from the benzodiazepine recognition site on the gamma-aminobutyric acid receptor (RECEPTORS, GABA). It also binds medium- and long-chain acyl-CoA esters and serves as an acyl-CoA transporter. This peptide regulates lipid metabolism.
Severe HYPOGLYCEMIA induced by a large dose of exogenous INSULIN resulting in a COMA or profound state of unconsciousness from which the individual cannot be aroused.
Sudden temporary alterations in the normally integrative functions of consciousness.
A potent benzodiazepine receptor antagonist. Since it reverses the sedative and other actions of benzodiazepines, it has been suggested as an antidote to benzodiazepine overdoses.
Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain.

Idiopathic recurrent stupor mimicking status epilepticus. (1/5)

Stupor is defined as a deep sleep or behaviourally similar unresponsiveness from which the subject can be aroused only by vigorous repeated stimuli. Causes of stupor may be related to brain damage, toxic or metabolic encephalopathies. Idiopathic recurring stupor is a stupurous condition of unknown aetiology, unrelated to structural, toxic or metabolic disturbance. This condition responds to flumazenil, a benzodiazepine antagonist. We describe a 60-year-old man presenting with abnormal jerky movements of the body and who was wrongly treated as status epilepticus. He responded to flumazenil which confirmed the diagnosis.  (+info)

Endorsement of the FOUR score for consciousness assessment in neurosurgical patients. (2/5)

The Full Outline of UnResponsiveness (FOUR) score was previously developed for neurological assessment, but has not been validated in neurosurgical patients, so was compared to the Glasgow Coma Scale (GCS) in practice. Four groups of raters, expert clinicians, novice clinicians, experienced nurses, and inexperienced nurses, assessed 64 patients in awake, drowsy, stuporous, and comatose conditions to investigate rater reliability. Then, 36 patients were evaluated by 1 expert clinician and 1 from the other groups randomly to test the difference. Spearman's correlation was used to find the correlation between both scores from 68 patients. The estimation of FOUR score cut points was validated by weighted kappa compared with the GCS to establish the risk prognosis. Score feasibility was analyzed by nonparametric test. Intraclass correlation in each group was over 0.9, with no difference between expert and inexperienced raters (p > 0.05). The correlation was 0.78. Low, intermediate, and high risk prognosis were associated with 0-7, 8-14, and 15-16 FOUR scores with kappa of 0.92. The feasibility of the FOUR score was lower than that of the GCS (p < 0.01). The FOUR score is reliable and valid for consciousness evaluation with some consequences for practicability. Extensive implementation would increase familiarity.  (+info)

Retrospective and observational study to assess the efficacy of citicoline in elderly patients suffering from stupor related to complex geriatric syndrome. (3/5)

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Aspiration pneumonia caused by inadvertent insertion of gastric tube in an obtunded patient postoperatively. (4/5)

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Altered mental status in older patients in the emergency department. (5/5)

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Stupor, in medical terms, is a state of impaired consciousness and responsiveness. A person in a stupor is unresponsive to most or all stimuli, but can be aroused briefly by strong stimulation such as sharp pain or loud noise. However, they quickly return to their unresponsive state once the stimulus is removed. It's a condition that lies between lethargy and coma on the spectrum of decreased levels of consciousness. Prolonged stupor may indicate serious underlying conditions like brain injury, infection, or severe metabolic disturbances.

A coma is a deep state of unconsciousness in which an individual cannot be awakened, cannot respond to stimuli, and does not exhibit any sleep-wake cycles. It is typically caused by severe brain injury, illness, or toxic exposure that impairs the function of the brainstem and cerebral cortex.

In a coma, the person may appear to be asleep, but they are not aware of their surroundings or able to communicate or respond to stimuli. Comas can last for varying lengths of time, from days to weeks or even months, and some people may emerge from a coma with varying degrees of brain function and disability.

Medical professionals use various diagnostic tools and assessments to evaluate the level of consciousness and brain function in individuals who are in a coma, including the Glasgow Coma Scale (GCS), which measures eye opening, verbal response, and motor response. Treatment for coma typically involves supportive care to maintain vital functions, manage any underlying medical conditions, and prevent further complications.

Consciousness disorders, also known as altered consciousness, refer to conditions that affect a person's awareness or perception of their surroundings, themselves, or their current state. These disorders can range from mild to severe and can be caused by various factors such as brain injury, illness, or the use of certain medications.

There are several types of consciousness disorders, including:

1. Coma: A state of deep unconsciousness in which a person is unable to respond to stimuli or communicate.
2. Vegetative State: A condition in which a person may have sleep-wake cycles and some automatic responses, but lacks awareness or the ability to interact with their environment.
3. Minimally Conscious State: A condition in which a person has some degree of awareness and may be able to respond to stimuli, but is unable to communicate or consistently interact with their environment.
4. Delirium: A state of confusion and altered consciousness that can occur suddenly and fluctuate over time. It is often caused by an underlying medical condition or the use of certain medications.
5. Locked-in Syndrome: A rare condition in which a person is fully conscious but unable to move or communicate due to complete paralysis of all voluntary muscles except for those that control eye movement.

Treatment for consciousness disorders depends on the underlying cause and may include medication, therapy, or surgery. In some cases, recovery may be possible with appropriate treatment and rehabilitation. However, in other cases, the disorder may be permanent or result in long-term disability.

A Diazepam Binding Inhibitor (DBI) is a protein that inhibits the binding of benzodiazepines, such as diazepam, to their receptor site in the central nervous system. DBI is also known as the alpha-2-macroglobulin-like protein 1 or A2ML1. It is involved in regulating the activity of the GABA-A receptor complex, which plays a crucial role in inhibitory neurotransmission in the brain. When DBI binds to the benzodiazepine site on the GABA-A receptor, it prevents diazepam and other benzodiazepines from exerting their effects, which include sedation, anxiety reduction, muscle relaxation, and anticonvulsant activity.

An Insulin Coma is not a formal medical term, but it has been used in the past to describe a deliberate medical procedure known as Insulin Shock Therapy. This was a treatment for mental illness that involved administering large doses of insulin to induce hypoglycemia (low blood sugar), which could lead to a coma.

The idea behind this therapy, which was popular in the mid-20th century, was that the induced coma and subsequent recovery could have therapeutic effects on the brain and help alleviate symptoms of mental illnesses like schizophrenia. However, this treatment fell out of favor due to its significant risks and the development of more effective and safer treatments.

It's important to note that in current medical practice, inducing a coma with insulin is not a standard or recommended procedure due to the potential for severe harm, including brain damage and death.

Dissociative disorders are a group of mental health conditions characterized by disruptions or dysfunctions in memory, consciousness, identity, or perception. These disturbances can be sudden or ongoing and can interfere significantly with a person's ability to function in daily life. The main types of dissociative disorders include:

1. Dissociative Amnesia: This disorder is characterized by an inability to recall important personal information, usually due to trauma or stress.
2. Dissociative Identity Disorder (formerly known as Multiple Personality Disorder): In this disorder, a person exhibits two or more distinct identities or personalities that recurrently take control of their behavior.
3. Depersonalization/Derealization Disorder: This disorder involves persistent or recurring feelings of detachment from one's self (depersonalization) or the environment (derealization).
4. Other Specified Dissociative Disorder and Unspecified Dissociative Disorder: These categories are used for disorders that do not meet the criteria for any of the specific dissociative disorders but still cause significant distress or impairment.

Dissociative disorders often develop as a way to cope with trauma, stress, or other overwhelming life experiences. Treatment typically involves psychotherapy, including cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), as well as medication for co-occurring conditions such as anxiety or depression.

Flumazenil is a medication that acts as a competitive antagonist at benzodiazepine receptors. It is primarily used in clinical settings to reverse the effects of benzodiazepines, which are commonly prescribed for their sedative, muscle relaxant, and anxiety-reducing properties. Flumazenil can reverse symptoms such as excessive sedation, respiratory depression, and impaired consciousness caused by benzodiazepine overdose or adverse reactions. It is important to note that flumazenil should be administered with caution, as it can precipitate seizures in individuals who are physically dependent on benzodiazepines.

Electroencephalography (EEG) is a medical procedure that records electrical activity in the brain. It uses small, metal discs called electrodes, which are attached to the scalp with paste or a specialized cap. These electrodes detect tiny electrical charges that result from the activity of brain cells, and the EEG machine then amplifies and records these signals.

EEG is used to diagnose various conditions related to the brain, such as seizures, sleep disorders, head injuries, infections, and degenerative diseases like Alzheimer's or Parkinson's. It can also be used during surgery to monitor brain activity and ensure that surgical procedures do not interfere with vital functions.

EEG is a safe and non-invasive procedure that typically takes about 30 minutes to an hour to complete, although longer recordings may be necessary in some cases. Patients are usually asked to relax and remain still during the test, as movement can affect the quality of the recording.

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