[Anatomo-clinical conference. Hôpital de la Pitié-Salpêtrière. Case No. 7 - 1983. Severe electrolyte disorders, consciousness disorders and tetraplegia].
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A clinical study of 183 patients detected the absence of a syndromological uniformity in the mussitative variant of delirium tremens. The dynamical clinical picture of psychosis may include during one of the stages of its development a delirious-amentive syndrome, short-time amentive states and oniric experiences. The seen variants of disordered consciousness have a tendency to a transition to clouded forms which subsequentive lead to a significant drop of socio-labour capacity making such disorders prognostically extremely significant. An analysis of "lucid periods" in this contingent demonstrated their affinity to one of the mild forms of disordered consciousness.
In order to study the systemic brain activity in disorders of consciousness, 40 epileptic patients with twilight states were examined during the intra-attack period by the clinical methods and evoked potentials technique. An analysis of the amplitude-tempolabile waves of evoked potentials permitted to detect certain traits in the functioning of the afferent brain systems during twilight states and after egress from psychosis. An attempt has been made to explain on the basis of the data obtained the mechanisms of the clinical symptomatology in the test group of patients.
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The most important neurological disorders leading to syncope and/or drop attack are presented. With respect to epilepsy it is important to consider generalized absence seizures (petit mal), generalized tonic-clonic seizures (grand mal) and some types of complex partial seizures. Additionally, some sleep and arousal disorders must be mentioned, such as narcolepsy, disorders of excessive somnolence associated with sleep-induced respiratory impairment, as well as the Kleine-Levin-Critchley syndrome. Vagotonic, asympathicotonic, sympathicotonic and central autonomic disorders are comprised in the group of autonomic attacks. Among other brain diseases manifesting syncope and/or drop attack, cerebrovascular disorders are of major importance in view of their high incidence. Psychogenic seizures also have to be taken into account in the differential diagnosis.
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