Psychogenic nonepileptic seizures (PNES) can present emergently and are often mistaken for epileptic seizures. A number of pharmaceuticals may be used in an attempt to bring the polydipsia under control, including: There are a number of emerging pharmaceutical treatments for psychogenic polydipsia, although these need further investigation:[35], Lithium was previously used for treatment of PPD as a direct competitive ADH agonist, but is now generally avoided due to its toxic effects on the thyroid and kidneys. The neurology diagnosis was “psychogenic. Hysteria as a cause of failure to recover consciousness following general anaesthesia is a rare event. The pressure on the fingernail is a common method and can suffice for a coma assessment: The use of the Glasgow coma scale, which was already developed in the 1970s, continues to be established in the clinical world. If you have an individual subscription to this content, or if you have purchased this content through Pay Per Article within the past 24 hours, you can gain access by logging in with your username and password here: This site uses cookies. Your email address will not be published.

Hysterical pseudo-coma corresponds to a state of clinical sleep with contrasting waking electroencephalogram. Herein we describe a 49-year-old woman with a history of depression, for which she was receiving treatment, who did not awaken promptly after use of general anesthesia for ethmoidectomy. USMLE Step 3 Neurology. According to the ancient Greeks, a coma is nothing more than ‘deep sleep’. Weber, J. G., Cunnien, A. J., Hinni, M. L. Weber, Joseph G. ; Cunnien, Alan J. ; Hinni, Michael L. @article{f96fd20076ae4a5a9415b615606a319e.

Background: Locked-in syndrome (LIS), also known as cerebromedullospinal disconnection or

roommates were given an eviction notice for unpaid rent.

AB - Failure of a patient to awaken promptly after use of general anesthesia may be due to various causes, including medication-related effects, neurologic insults, or metabolic disturbances. doi = "10.1016/s0025-6196(11)64846-5", Otolaryngology- Head & Neck Surgery/Audiology, https://doi.org/10.1016/s0025-6196(11)64846-5. According to DSM-IV-TR, psychogenic coma is a dissociative disorder not otherwise specified. Login failed. © EEG and Clinical Neuroscience Society (ECNS) 2015. Psychogenic Coma after Use of General Anesthesia for Ethmoidectomy. This case report describes such an instance in a young, healthy 22-year-old female suffering severe dental phobia who was undergoing dental conservation. In the latter, the patients are only aroused by very strong stimuli. We hereby present three cases, who presented with mutism as the presenting symptom and the differential diagnosis and management issues related to these cases are discussed.

[17][18][19] The following conditions should also be excluded: DI, cerebral salt wasting, pseudohyponatraemia caused by hyperlipidemia or hyperparaproteinemia, SIADH, mineralcorticoid deficiency, salt-wasting nephropathy, nephrotic syndrome, chronic heart failure and cirrhosis.[20].

These disorders comprise the so-called pseudoneurologic syndromes, which can mimic almost any organic disease. Presenting syndromes can include pseudoparalysis, pseudosensory syndromes, pseudoseizures, pseudocoma, psychogenic movement disorders and pseudoneuro-ophthalmologic syndromes. Weight will normally fluctuate during the day, but as the water intake of the polydipsic goes up, the weight will naturally rise. The desmopressin test is also used, in which the synthetic hormone is used as a diagnostic workup to test for inappropriate secretion of vasopressin, as seen in DI and SIADH. Mann, J . MRI scans may be used to help with differentiating between PPD and diabetes insipidus, such as by examining the signal of the posterior pituitary (weakened or absent in central DI).

Can make a thumbs up, peace, or fist ‘responds to the command’, Open spontaneously but does not track your fingers ‘does not respond to the command’, Infection including meningitis and encephalitis, The danger of infection, e.g., lung infection, Say/yell the patient’s name (verbal stimulation), Press on patient’s nail beds (peripheral painful stimulation), Sternal rub/nasal swab (central painful stimulation).

Access scientific knowledge from anywhere. The person is alive and looks like he or she is sleeping. No one can know whether the cerebrum of these patients has actually failed—or whether it simply does not communicate with the outside world. J. PSYCHIATRY IN MEDICINE, Vol. Primary polydipsia, or psychogenic polydipsia, is a form of polydipsia[1] characterised by excessive fluid intake in the absence of physiological stimuli to drink. If the patient is institutionalised, monitoring of behaviour and serum sodium levels is necessary. Read more about the editorial team, authors, and our work processes. Coma threatens the body due to the failure of important protective reflexes and the lack of regulation of the vital functions. [13] This means that psychogenic polydipsia may lead to test results (e.g. Deviation of the eyes towards the ground with the patient lying on each side is proposed as a diagnostic sign in psychogenically mediated states resembling coma or epilepsy. [22] Diagnostic tests for primary polydipsia usually involves the fluid deprivation test to exclude ADH problems. Patients do of course lie to us, but many patients have psychogenic coma, where they are not intentionally fabricating the coma, which arises from psychological distress and is termed a conversion reaction.

UR - http://www.scopus.com/inward/record.url?scp=0030317631&partnerID=8YFLogxK, UR - http://www.scopus.com/inward/citedby.url?scp=0030317631&partnerID=8YFLogxK, Powered by Pure, Scopus & Elsevier Fingerprint Engine™ © 2020 Elsevier B.V, "We use cookies to help provide and enhance our service and tailor content. This ‘waking coma’ can last for months or a whole lifetime. Management is largely supportive.

The International Journal of Psychiatry in Medicine, A Clinically Oriented Perspective on Psychogenic Nonepileptic Seizure-Related Emergencies, Dissociative disorders causing unconsciousness and collapse during oral surgery treatment, [A case of delayed awakening from general anesthesia caused by psychological unresponsiveness], Repeated episodes of difficulty with arousal following general anesthesia in a patient with ulnar neuropathy, An unusual case of hysterical postoperative coma, FACTITIOUS DISORDER AS A CAUSE OF FAILURE TO AWAKEN AFTER GENERAL-ANESTHESIA, Diagnostic and Statistical Manual of Mental Disorders: DSM-V, A diagnostic sign in states of apparent unconsciousness, Hysteria.

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