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

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

Labyrinthine hysteroid-neurotic syndromes are often a component of the general hysteroid-neurotic syndrome, either combined with other neurotic symptoms or manifested as a monosyndrome. In this case, labyrinthine hysteroid-neurotic syndromes, as a rule, are a dissociated syndrome.

Hysterical deafness is a real manifestation of hysteria and does not belong to the category of simulation or aggravation. As a rule, this syndrome occurs in people prone to neuropathic conditions, emotionally labile, often suffering from some somatic disease. Labyrinthine hysterical-neurotic syndromes often provoke mental affects, real experiences. Most often they occur in young people during global cataclysms, during war, in school and army groups. Women suffer more often.

Hysterical deafness always occurs suddenly, is usually bilateral and is accompanied by other manifestations of hysteria (anesthesia, hyperesthesia, paralysis, visual impairment, etc.).

Diagnosis of hysterical deafness is quite difficult. The leading place in it is occupied by methods of exclusion of organic diseases of the central nervous system and the organ of hearing, as well as simulation of deafness. The latter, unlike hysterical deafness, is a conscious act pursuing a certain goal. When making a positive diagnosis, the type of higher nervous activity and preceding psychoemotional factors, the suddenness of the onset of deafness, the presence of auro-palpebral, auro-pupillary and acoustic reflexes of the stapedius muscle, the patient's lack of interest in the movements of the articulatory apparatus (the patient does not pay attention to the movements of the lips of the person addressing him), the disappearance of deafness during sleep (the patient can be awakened by sounds that he did not perceive while awake) are taken into account.

Audiometry reveals an increase in differential thresholds of sound intensity and frequency (if the patient is capable of a certain perception of sounds and speech), a sharp deterioration in speech intelligibility under conditions of sound interference, normal hearing when examining the acoustic conditioned psychogalvanic reflex, and the absence of changes in evoked auditory potentials.

Hysterical deafness may be accompanied by peculiar auditory "hallucinations" similar to those that occur in auditory hallucinatory syndromes. The difference is that a patient with true auditory hallucinations retains normal hearing and does not exhibit other signs of a hysterical seizure. In addition, true auditory hallucinations often contain verbal and imperative components and never cause patients to doubt their truthfulness and intentionality. Auditory hallucinations in hysteria are not organized into any verbal constructions, are inconsistent in quality, do not serve as imperative instructions for the patient, and upon exiting the state of a hysterical seizure, they are either forgotten or the patient critically comprehends them.

Hysterical vestibulopathy is a rarer condition. The patient complains of extreme dizziness, but is unable to describe the nature of this dizziness, as is the case with true vestibular dysfunction; spontaneous nystagmus is absent. Deviations of the limbs during pointing tests are unsystematic, with an increased amplitude that is not found in true vestibular dysfunction. In the Romberg position, the patient usually deviates or falls in the direction in which he is not in danger of injury, for example, into a chair or onto a couch. Provocative vestibular tests remain normal.

Treatment of labyrinthine hysteroid-neurotic syndromes is psychotherapeutic with the use of sedatives and tranquilizers, carried out under the supervision of a neurologist and psychotherapist. At the same time, the patient is examined for the presence of hidden foci of infection and other diseases.

[ 1 ], [ 2 ]