Symptoms

Stupor – Ursachen, Behandlung & Hilfe

Stupor

Stupor is a symptom of a mostly mental illness. It is characterized by the fact that the body falls into a state of rigidity despite being awake. In extremely severe cases, a stupor can also indicate a life-threatening mental illness.

What is a stupor?

Stupor describes a state of physical rigidity despite being conscious. It occurs as a symptom of various mental or brain diseases . The patients cannot react when spoken to, although they perceive everything. The stupor is often accompanied by increased muscle tone, fever and disorders of the autonomic nervous system. Certain characteristics such as muscle tone, eye movements or eye opening indicate an awake state.

A stupor often occurs together with mutism (dumbness). Those affected do not react at all or only slightly to environmental stimuli. However, they perceive these stimuli with particular sensitivity. Eating and drinking is also made more difficult, so patients with stupor sometimes have to be fed artificially. In particularly severe forms of stupor, catalepsy can even occur.

Catalepsy is characterized by a so-called waxy increase in muscle tone, in which a change in position of the limbs, once passively induced, is maintained immobile for a long period of time. Even the most uncomfortable positions of the joints remain.

Causes

The causes of a stupor are varied. Many mental illnesses can trigger a stupor. Severe depression can lead to so-called depressive stupor. Those affected appear resigned and at the same time are at high risk of suicide. A schizophrenic psychosis is usually the cause of catatonic stupor .

This is characterized by catalepsy and is extremely life-threatening as a result of increased physical reactions such as fever or mineral metabolism disorders. The psychogenic stupor is caused by previous trauma or other stressful experiences. There is no evidence of schizophrenia , depression or organic causes.

An organically caused stupor can be triggered, among other things, by meningitis , encephalitis (brain inflammation), epilepsy , other seizure disorders, brain tumors , cerebral edema , dementia , liver diseases , hormonal diseases or an increased potassium level. A stupor can also occur as part of Parkinson’s disease .

The same applies to acute porphyria and diabetic ketoacidosis . Medications can also cause a stupor. In particular, it can occur as a side effect when using neuroleptics . Finally, poisoning with drugs such as PCP or LSD often leads to a stupor. The uncontrolled intake of sleeping pills and hypnotics (barbiturates, benzodiazepines) as well as opiates are also frequent causes of the state of torpor.

Diseases with this symptom

Diagnosis & History

To diagnose the stupor, the doctor will first take the medical history. Since stupor patients cannot be spoken to, the next of kin are interviewed. The first step in the anamnesis is to find out whether mental illnesses are already present or have existed in the past. During the physical exam, the doctor checks the patient’s muscle tone and response to voice and pain stimuli.

Laboratory tests for blood , cerebrospinal fluid or spinal fluid can provide information on possible organic diseases. This is followed by neurological examinations, measurements of electrical brain waves ( EEG ) and imaging procedures such as magnetic resonance imaging . All examinations serve to determine whether organic or psychological causes are responsible for the stupor.

The manifestations of a stupor often also depend on the cause. So it is also important for the doctor to recognize the correct shape from external features. If, for example, catalepsy is present, the doctor can assume a catatonic stupor, which sometimes occurs in the context of schizophrenia. This condition is very life threatening. If a stupor persists for a long time, the striated muscles sometimes dissolve ( rhabdomyolysis ).

Rhabdomyolysis often leads to acute kidney failure . Other complications of a stupor are pneumonia with sepsis, thrombosis , skin ulcers or electrolyte imbalances . In these cases, for the right treatment, the doctor must unequivocally diagnose or rule out the stupor as the cause of the complications.

Complications

A stupor usually develops as a result of mental illnesses, which can be associated with various consequences. Common complications of a stupor are the breakdown of the skeletal muscles ( rhabdomyolysis ). It can also lead to kidney failure (renal insufficiency). Pneumonia, which can progress to sepsis, or thrombosis and ulcers are other conceivable consequences of a stupor.

Typically, a stupor develops with depression. These can often be accompanied by anxiety or panic disorders . Those affected no longer dare to go public and isolate themselves socially, which only intensifies the symptoms. Compulsive disorders can also occur. Affected people sometimes suffer from hallucinations and have psychoses, often leading to insanity.

It is not uncommon for those affected to take drugs or drink alcohol to escape their worries. Frequent drug use only increases the symptoms of hallucinations and psychoses. Alcohol can also cause cirrhosis of the liver, the liver is no longer functional and can progress to liver cancer.

Eating disorders can also affect sufferers. You either eat more or less, which can lead to bulimia or obesity . Both secondary diseases are associated with an increased risk of developing cardiovascular diseases. This is also favored by the often associated lack of sleep. In the worst cases, the depressed person commits suicide. About 15 percent take their own lives during the course of the disease.

When should you go to the doctor?

If there is a suspicion of a stupor, it makes sense to see a doctor in any case. The family doctor or a general practitioner can serve as the first point of contact. Since the stupor can be due to various causes, a referral to a specialist doctor may be necessary after initial examinations. Those affected should definitely use such a transfer.

In an acute situation, an emergency doctor can also be called in. This is especially true when it is unclear whether it is a stupor or another clinical picture. Outsiders often cannot tell whether the person concerned is conscious. Other diseases and syndromes can look very similar. This includes serious illnesses such as stroke, which require immediate treatment. Therefore, it makes sense to make an emergency call, especially in such a unclear and acute situation.

For the same reason, self-diagnosis should be viewed very critically. There is a risk that other causes will be ignored, resulting in serious complications.

There may already be a known disease that can trigger the stupor. In this case, those affected can (possibly after an initial clarification) also contact their treating specialist themselves. However, they should not let too much time pass by.

Treatment & Therapy

The treatment of a stupor depends on the underlying disease. In the case of an organically caused stupor, the disease that may be present, such as meningitis , encephalitis, cerebral edema or brain tumor, must be treated. After the organic cause has healed, the stupor also disappears. Catatonic stupor is treated with neuroleptics such as fluphenazine or haloperidol.

In addition, sedatives and anxiety relievers can also be used. Anxiolytics are particularly helpful in the case of a psychogenic stupor. When depressive stupor is present, antidepressants are used. Neuroleptics can also be prescribed in this case. Electroconvulsive therapy (ECT) can help in some cases . A seizure is provoked by electrical impulses. This treatment must be repeated on several consecutive days. There is hardly any health risk with this therapy.

Even if a stupor patient does not respond to being spoken to, it is very important that all the people involved continue to care. Former patients describe the constant contact and attention as trust-building and relieving. In the case of a psychogenic stupor, a calm and non-irritating atmosphere can often even make a therapeutic conversation possible. Furthermore, constant monitoring of the vital functions is important in order to be able to identify complications quickly.

Outlook & Forecast

The prognosis for stupor depends on the length of the acute condition and the triggering cause of the loss of consciousness. Recovery is considered likely if the patient is responsive within 6 hours. If speech returns in the coming days or if the eyes are subject to voluntary movement, there is also a good chance of a cure.

Indications of a positive development are following instructions and responding appropriately to different speeches. The cognitive understanding and the substantive reaction to events is important for a good healing success.

The prospects are less good if the pupils do not contract when exposed to light. If the patient cannot follow an object with their eyes, this is also an indication of incomplete recovery.

If there is an increase in seizures or a prolonged seizure within the first few days of the stupor , recovery is considered unlikely. If the person concerned is unable to move their hands or legs in a targeted manner after more than a week, the state of health is also classified as problematic.

Prevention

A stupor can only be prevented if the underlying disease is known. Getting your best treatment will help avoid torpor as a complication. There is no general prophylaxis for stupor due to the many possible causes.

You can do that yourself

Stupor is a state of absolute paralysis that can become life-threatening. The affected person is conscious but can hardly move. In addition, fever and muscle stiffness can occur, and the normal urge to urinate and bowel movements are no longer present. A common background is severe mental illnesses such as catatonic schizophrenia. However, the administration of certain psychotropic drugs can also trigger a stupor. This is especially true for certain neuroleptics .

Self-help is almost impossible in an acute stupor. This can only be resolved pharmacologically. Therefore, an inpatient setting is necessary for acute treatment.

However, through self-care in cooperation with medical professionals, those affected can strive to change their basic drug settings that can trigger a stupor. If such a condition has occurred (possibly several times), it is appropriate to change the medication with psychotropic drugs and to strive for alternatives to the treatment of the underlying disease.

In addition, patients who notice that a stupor is imminent should seek medical help from professionals, such as a neurologist , very quickly . However, since this often occurs in combination with serious mental illnesses and strong psychopharmacological medication, it is difficult for those affected to react in time. Self-medication through the administration of relaxing agents that dissolve rigidity is problematic and often not feasible.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.