One of the disorders of the dynamics of thinking, mental delay of the thinking process, manifested by blocking thoughts that lose their connectedness and focus, which interrupts the associative process and is accompanied by a short-term stupor, is called sperrung. It is manifested by the sudden cessation of the train of thought, the cessation of thinking, speech and activity. Most experts attribute to sperrung and breakage of thoughts, their sudden loss, instantaneous silence and transition to another topic, in fact not accompanied by a noticeable stupor, believing that these are different degrees of manifestation of the same state.
Causes şperrunga
In principle, such a mental blockade can occur in any person as a result of a strong emotional shock. In this case, the pathology of thinking is not observed, however, a periodic disorder of the thinking process speaks of the need for examination by a psychiatrist, since sperrung is most often a symptom of schizophrenia, which can occur in epileptics, autists, and Chorea, in chorea. The causes of the periodic occurrence of pathological cliffs of thought are attributed to psychiatric or neurological diseases. .
The risk factors for its occurrence are varied. This is, first of all, heredity, which plays a major role in the development of diseases such as schizophrenia and epilepsy. Injuries and tumors, intoxication, inflammation of the brain structures and degenerative processes of various origins - any factors that affect blood circulation and metabolism, can cause biochemical changes in the brain and trigger the pathogenesis of thought disorder.
Reversible episodes of cessation of mental activity occur under the influence of stress factors in sensitive individuals who are prone to getting stuck, self-doubt, irritable, and have certain difficulties with adaptation in society. Eigen Bleuler wrote that such a blockage of thinking, psychomotor delay, occurs under the influence of affect in all nervous people, in particular, hysteroid personalities are subject to it. Sperrung itself is not a pathology. But where the delay in the thinking process lasts a long time or occurs very often for no apparent reason, one can be suspected of having schizophrenia.
Sperrung as a symptom demonstrates the presence of a mismatch in the functioning of the brain systems. The thought, activated by unconditional stimuli, begins to form, conditional reflexes and speech analyzers are connected and at some stage the process is interrupted. The thought disappears, the person becomes silent for a certain time. Then the ability to think returns, and the course of the interrupted process is not restored. The person switches to another topic. What kind of neurobiological processes involved in the formation of this symptom is not yet known. In epileptic superrung sufferers, the temporal lobes of the brain are affected.
Symptoms şperrunga
The first signs of cessation of mental activity are expressed in the fact that a person suddenly becomes silent or interrupts some activity for a few seconds or minutes, in severe cases - hours, and then cannot return to the previous topic, although the ability to communicate and act returns. And the man is aware that his thought has disappeared and the course of the thinking process is interrupted. Schizophrenics suffering from this symptom, explain this by the fact that someone steals their thoughts.
At the time of the shutdown, mental activity stops, the individual stops responding to surrounding events, does not respond to questions, freezes for a while, and consciousness is not lost. At the time of mental blocking, his ability to associate to think, perceive what is happening, speak and act is lost. After the restoration of mental ability, a person can describe what happened to him - his thoughts have completely disappeared, void in his head, or fragments of thoughts swarm. Emil Kraepelin interpreted sperrung as a short-term episode of a catatonic stupor.
Often, people who have short-term cliffs of thought try to hide their peculiarity from the interlocutor. Such a "trick" manifests itself by switching attention to a completely different topic, jumping from one thought to another, with the previous one ending in the middle of a phrase. A ragged thought cannot be immediately restored, but later, sometimes in a couple of days, it is suddenly remembered without any effort. Cliffs (deprivation) of thoughts are much more common than the full blockage of thinking sperrung. Patients describe the subjective sensations as the loss of current thought, which is accompanied by a feeling of mild confusion. Everything that has already been said and supposed to be said further falls out of memory. However, mild forms of loss of thought to the other person may not be noticeable.
The opposite symptom of thinking disorder is mentality. This is an uncontrollable influx of a multitude of unrelated thoughts. They are characterized by a quick change, in which one thought, interrupted at any place, can be replaced by the next one, which also cannot be thought out to the end. The stream of thoughts can have any content, both joyful and negative, but in any case it tires the individual very much, keeps him in suspense. The violent flow of thoughts of any kind prevents normal thinking, even a short-term state leads to mental exhaustion of the patient.
Mentism and sperrung are symptoms of thought disorder characteristic of schizophrenia. Patients are not able to control the flow of images and memories, unable to control them, feel their strangeness. They complain that they put their thoughts into the head from the outside, transmit them via an implanted transmitter, etc.
Both an influx and a cliff of thoughts is in most cases a painful disorder, deprives a person of the ability to reason sensibly, causes a slowdown in thinking and is very painful for the patient.
Complications and consequences
Obstruction thinking sperrung itself is not dangerous. The ability to think, speak and act is usually restored fairly quickly.
However, as a symptom of schizophrenia, it presents a serious danger. It is necessary to think about visiting a psychiatrist when such states arise periodically on their own, and not under stressful conditions, such as, for example, in an exam. Prolonged cessation of mental activity is also an alarming sign.
Untreated schizophrenia has a progressive course. Patients lose the ability to adequately assess the situational and reaction to the events, they have violated behavioral control and self-organization of activity in everyday life and at work. They become dependent on outside care, which provokes a depressive mood, contributes to the formation of antisocial behavior, increases the likelihood of suicide.
Diagnostics şperrunga
If there is such a symptom as sperrung, a comprehensive examination of the patient is necessary, including a detailed psychiatrist interview, testing, and consultation with a neurologist.
Assigned laboratory tests to assess the overall health and instrumental diagnostics, which gives an idea of the functioning of the brain: electroencephalography, ECHO encephalography, magnetic resonance imaging.
Differential diagnosis, first of all, should confirm or exclude the presence of schizophrenia in a patient. This disease is characterized by a wide range of symptoms and sperrung as a violation of harmony of thinking is considered one of the main ones.
Affective disorders are distinguished from mental illness by the lack of personal changes in a patient.
Differential diagnosis
Differentiate between themselves and mental pathologies. In epileptics, sperrung can develop in anticipation of seizures, autism also differentiates. Autistic people usually do not notice social signals from other people, they have reduced motivation for social interaction, schizophrenics can communicate, they all notice, but they misinterpret everything, create an incorrect picture of the world in accordance with their painful perception.
Treatment şperrunga
The purpose of therapeutic measures is determined by the nature of the underlying disease. In schizophrenia and epilepsy, pharmacotherapy is the main treatment. Such patients, in general, take medicines throughout their lives, which allows them to maintain its quality at a practically normal level.
The main drugs for the treatment of schizophrenia are neuroleptics. The antipsychotic effect of this group of drugs is realized through the blockade of central dopaminergic and α-adrenoreceptors. Drugs in this group have the ability to influence the frequency and intensity of nucleation of nerve impulses in different parts of the central nervous system and their transfer to the periphery. They are able to influence the metabolic processes in the cerebral cortex, improve cognitive functions and activate thinking.
Depending on the observed symptoms, different generations of drugs are used (Aminazine, Clozapine, Olanzapine, Risperidone, Sertindol, Aripiprazole), all of them have a wide range of side effects. Their direct effects are associated with the main neuroplegic side effects they cause — muscle numbness, persistent muscle spasms, tremors in the limbs, and other extrapyramidal reactions. Especially typical antipsychotics are famous for such effects, newer drugs (atypical) drug parkinsonism cause less and are more suitable for long-term (permanent) use. They are better tolerated and provide a low incidence of side effects (extrapyramidal, hyperprolactinemia, weight gain, cardiovascular dysfunction, and others).
Neuroleptics enhance the effect of other sedatives, inhibits various reflex activity, providing the physiological processes of homeostatic regulation of the functions of internal organs.
The absolute contraindications to the use of antipsychotics are severe systemic pathologies of the brain and spinal cord, inflammatory and degenerative diseases of the liver and kidneys, decompensated heart disease, impaired hematopoiesis, myxedema, and thrombosis of blood vessels.
Dosing drugs individually, to deviate from the treatment regimen proposed by the doctor is not recommended. When the course is interrupted, withdrawal occurs, so the drug should be withdrawn gradually and under the supervision of a physician. You can not change the dosage yourself.
If a patient has symptoms of depression, antidepressants are added to the treatment regimen. In the presence of comorbidities, appropriate therapy is prescribed, based on known drug interactions.
Epileptics are shown anticonvulsants - Lamotrigine, Finlepsin, valporoaty.
Lamotrigine usually has a rapid anticonvulsant effect, moreover, this drug does not adversely affect the ability to remember information, concentration and mental abilities, like other anticonvulsants. It interrupts the transmission of nerve impulses, providing the release of an aliphatic amino acid - glutamate, the excess of which provokes the occurrence of seizures. Eliminating epileptic seizures, the medicine relieves the patient from the symptoms characteristic of the prodromal phase, including superrung.
Another anticonvulsant Finlepsin has a more pronounced anticonvulsant effect, in addition, relieves hyperkinesis (which manifestations include mentism). In addition to anticonvulsant activity, the drug enhances the effects of antidepressants and increases the activity of neurotransmitters responsible for the stabilization of emotions, emancipation and productive brain activity.
For disorders of cerebral blood circulation, hypoxia, the effects of intoxication and injury, nootropic activity preparations are used.
Psychocorrection is also used - coursework with a psychologist is conducted in the form of group classes or according to an individual program. They are focused on restoring impaired thinking functions.
Prevention
To prevent the emergence of sperrung in healthy people is possible by increasing their resistance to stress, positivism and trying to avoid traumatic situations.
In sick people with the help of timely diagnosis and treatment of the underlying disease, the implementation of all medical recommendations.
Optimization of work and rest, nutrition and bad habits are relevant to all categories of the population.