Stupor: what is it, types, causes, symptoms and treatment

Let us reflect for a moment on each of the actions we take on this day. Walking, talking, reading, eating … many of them we do almost automatically, while others require effort.

However, each of them has something in common: they require a certain level of consciousness that allows us to perform them. And we don’t always have it, like when we sleep. Our level of consciousness can fluctuate greatly naturally.

However, certain illnesses, injuries or disorders can sometimes lead to an impaired state of consciousness from which we cannot get out. The most serious example is coma, but there are also other similar or very serious disorders or changes. This is the case with stupor, Which we will talk about throughout this article.

    What is stupor?

    It is possible that in more than one conversation we have heard or even used the term stupor to refer to a state of surprise that prevents us from reacting. It is a popular and valid use of the word, but it also has a medical meaning or significance.

    In this sense, it’s called stupor a condition or change in a person’s state of consciousness, In which there is a marked decrease in it. On the other hand, due to the altered state of consciousness of those who manifest stupor, their behavior also becomes very passive, barely reacting to the elements of the environment.

    Because of its implications, stupor indicates the presence of a very significant disturbance in the person’s mode of functioning, and the duration of this state is highly variable.

    symptoms

    Stupor is a state of loss or deficit of consciousness in which the subject remains in a semi-unconscious state and does not respond to environmental stimulation. It is practically impossible to get him out of this state unless a very intense and powerful stimulation is applied, which will manage to increase the alert slightly and temporarily. Some of the stimuli that can affect your condition are, for example, screaming or painful stimulation.

    The most notorious feature of this state is responsiveness and lack of voluntary movement, which separates stupor from other alterations in consciousness such as confusion or darkening and makes her the closest and closest state of consciousness to coma. It is, after the latter, the most profound alteration of consciousness.

    It is possible that in moments of consciousness, the subject makes small gestures or even makes small vocalizations or sounds, although these are inconsistent and unrelated to the context.

    It is important to note that this state is neither feigned nor voluntary, the lack of attention to the environment is therefore a consequence and not a cause of stupor. Cognitive activity is diminished by the absence of a state of alertness and attention and there is emotional indifference.

    type

    Although the concept of stupor is defined by the explanation given above, the truth is that it is possible to identify different types of stupor based on their cause and some specific related characteristics.

    1.organic stupor

    First of all, it should be mentioned that we can find a stupor of an organic type, in which the cause of this state is a neurological disorder of biological or acquired origin. This type of stupor is characterized by the tendency to appear against a background of diffuse brain dysfunction, and usually observes a lost gaze or closed eyes. In this state, you can take unusual actions.

    2. Psychiatric stupor

    Another major type of stupor is psychiatry, derived from some kind of psychopathology. There is mainly catatonic, melancholic / depressive and dissociative stupor.

    2.1. catatonic stupor

    It is a type of stupor that occurs in patients with catatonic-type schizophrenia. In that case flexibility of the ceria usually appears or maintaining the posture in which the subject is placed, with muscular hypertension. Silence, oppositional behaviors or automatic obedience can also be observed.

      2.2. melancholy stupor

      A subtype of stupor that appears in depressive pictures, more often in cases where depression is endogenous.

      In this case, the subject does not respond to stimuli due to a total inhibition of behavior and speech, and on the contrary that in other types of mutism, it is possible that there is a bodily expression which denotes sadness (although the emotion is also totally inhibited).

      2.3. dissociative stupor

      It is generally linked to the experimentation of any stressful or traumatic event, Which causes dissociation in the psyche of those who experience it. There is stillness, but if it is placed on the subject in a forced position, it returns to the original position. There is no resistance or muscle stiffness.

      Causes of the appearance

      As we can see, stupor is a condition that can arise for a wide variety of causes, both organically and psychologically.

      organic causes

      In organic causes we can find suffering from strokes or the possible acquisition of some type of infection in the brain or meningitis.

      The affected areas can be multiple and there is diffuse neuronal damage, but there can also be damage to the reticular activation system or SAR (Part of the brain responsible for maintaining wakefulness and located in the brainstem) or areas such as the supratentorial.

      Another possible cause could be the existence of a certain type of tumor, which can cause stupor if it squeezes or affects areas that govern consciousness, or if not enough blood, nutrients, and oxygen reach the brain. . Certain illnesses or suffering from severe hypoglycemia could also cause this condition.

      It can also occur in the face of food poisoning, by consumption of substances (including alcohol) or pharmacological. It is also possible for a person to go into stupor after suffering some type of traumatic brain injury. In these cases, stupor is due to damage, injury or impaired functioning of neurons.

      psychiatric disorder

      As for the stupor of the psychiatric type, this appears as a manifestation or symptom of different pathologies. Some of the most common are schizophrenia (especially in the old catatonic subtype) or even in cases of melancholic depression.

      The causes of these disorders are generally not known, although there are different hypotheses regarding each of these disorders. For example, the presence of aversive and traumatic events often triggers those of the dissociative type.

        Treatment of stupor

        The existence of some kind of stupor is a condition to be taken into account due to the lack of response and the ability to act and maintain normative functioning. For that you need go to the emergency room quickly in case this happens (Especially if it happens suddenly and suddenly).

        In general, it is first and foremost essential to ensure vital signs and biological stability, as well as to monitor their condition.

        It should be noted that stupor can be the symptom of an organic pathology or even of a cerebrovascular accident or of a head trauma, which can cause serious after-effects, a handicap or even death if you do not take care of yourself. Likewise, poisoning must also be treated differently.

        If the stupor is the product of an identifiable organically based pathology, complete recovery is not expected, although it is true that in some cases the symptoms disappear spontaneously after a certain time. Thus, in the case of psychiatric or neurological diseases, treatments are carried out to alleviate the negative consequences of the pathology, not to completely eliminate the stupor or other forms of disease expression.

        Subsequently and after analysis of the causes, the corresponding treatment will be applied in each case, according to its causes.

        Bibliographic references:

        • American Psychiatric Association (APA). (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
        • Berrios, GE (1981). Stupor: a conceptual story. Psychological medicine. 11: pages 677 to 688.
        • Martínez, MV and Sáez, ML (2007). Changes in the level of consciousness. Medicine: Accredited Medical Continuing Education Program, 9 (87): 5585-5591.
        • Plum, F. and Posner, JB (1972). The diagnosis of stupor and coma. Contemporary Neurology Series. 10: pages 1 to 286.
        • Sants, JL (2012). Psychopathology. CEDE PIR preparation manual, 01. CEDE: Madrid.

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