Labyrinth hysteroid-neurotic syndromes: causes, symptoms, diagnosis, treatment

Hysteria is a special form of neurosis, manifested by a variety of functional mental, somatic and neurological disorders that develops in individuals with a special nervous system, but also occurs in healthy people under certain conditions (weakening of the nervous system under the influence of psychogenic and somatogenic pathological factors).

Labyrinth hysteroid-neurotic syndromes often form an integral part of the common hysteroid-neurotic syndrome, either in combination with other neurotic symptoms, or manifest as a monosyndrome. In this labyrinthine hysteroid-neurotic syndrome, as a rule, is a dissociated syndrome.

Hysteroid deafness is a real manifestation of the disease by hysteria and does not belong to the category of simulation or aggravation. As a rule, this syndrome occurs in persons prone to neuropathic conditions, emotionally labile, often suffering from somatic disease. Often, labyrinthine hysteroid-neurotic syndromes provoke mental affects, real experiences. Most often occur in young people with global cataclysms, during the war, in school and army collectives. Women suffer more often.

Hysterical deafness always occurs suddenly, usually has a two-sided character and is accompanied by other manifestations of hysteria (anesthesia, hyperesthesia, paralysis, visual disturbances, etc.).

Diagnosis of hysterical deafness is rather difficult. The leading place in it is occupied by the methods of excluding organic diseases of the central nervous system and hearing organ, as well as the simulation of deafness. The latter, unlike the deafness of the hysterical, is an act of a conscious, pursuing a certain goal. When the positive diagnosis is made, the type of higher nervous activity and previous psychoemotional factors, the suddenness of the appearance of deafness, the presence of auro-palpebral, auropupillary and acoustic reflexes of the stremna muscle, the lack of interest of the patient to the movements of the articulatory apparatus (the patient does not pay attention to the movements of the lips referring to him) the disappearance of deafness during sleep (the patient can be awakened by sounds that he did not perceive in a waking state).

With audiometry, an increase in the differential thresholds of sound power and frequency is revealed (if the patient is capable of a certain perception of sounds and speech), a sharp deterioration in speech intelligibility, in conditions of sound interference, normal hearing in the study of acoustic conditioned psychogalvanic reflex, no change in the evoked auditory potentials.

Hysterical deafness can be accompanied by a kind of auditory "hallucinations", similar to those that occur with auditory hallucinatory syndromes. The difference lies in the fact that a patient with true auditory hallucinations maintains a normal hearing and does not have other signs of a hysterical fit. In addition, true auditory hallucinations often contain verbal and imperative components and never cause patients to doubt the truth and intentionality. Auditory hallucinations in hysteria are not organized into any verbal structures, they are impermanent in quality, they do not serve as imperative instructions for the patient and either are left in oblivion when they leave the state of hysterical fits or the patient critically interprets them.

Hysterical vestibulopathy is a rarer condition. The patient complains of severe dizziness, but it is not possible to describe the character of this dizziness, as is the case with true vestibular dysfunction; spontaneous nystagmus is absent. The deviation of the extremities for index tests is haphazard, with an increased amplitude that does not occur with true violations of the vestibular function. In the Romberg position, the patient usually deviates or falls in the direction in which he is not in danger of getting injured, for example, in an armchair or on a couch. Provocative vestibular tests remain normal.

Treatment of labyrinthine hysteroid-neurotic syndromes, psychotherapeutic with the use of sedative and tranquilizing agents, is conducted under the supervision of a neurologist and psychotherapist. At the same time, the patient is examined for hidden foci of infection and other diseases.

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