Ways to calm a person in hysterics. Description of the symptoms of hysteria. Causes and treatment Hysterical seizure first aid

A hysterical seizure is a type that is manifested by an indicative emotional state (tears, screaming, loud laughter, arching of the back, wringing of limbs), as well as convulsive and temporary seizures.

This type of disease has been known to scientists since ancient times. For example, Hippocrates carefully studied this phenomenon and called it “rabies of the uterus,” because this is a completely logical explanation.

It is known that hysterical attacks of this kind are observed in most cases in females; they occur much less frequently in children and are practically never found among men.

Modern researchers associate the disease with individual personality characteristics (character, temperament). The risk group includes those people who are prone to suggestion, fantasizing, have an unstable type of behavior and changeable mood. In order to somehow attract the attention of others, they resort to committing such non-standard actions.

If the disease is not diagnosed in a timely manner and its symptoms increase over time and become more pronounced, then treatment should only be carried out by a qualified psychiatrist. In each case, treatment is individualized and must be followed until complete recovery.

Factors provoking the development of hysteria

Like every mental illness, the main cause of the development of hysteria is disturbances occurring in the standard behavior of the individual. This also includes upbringing, character, temperament and resistance to suggestion.

In most cases, a person’s infantilism, hysterical manifestations of character, as well as a genetic predisposition to this type of disorder can cause a hysterical attack.

Various factors can cause a seizure, a special place among which is occupied by the following:

a person has serious illnesses internal organs;
frequent physical overexertion;
professional activity that does not bring proper satisfaction;
frequent conflicts and quarrels in the family circle;
recent injuries;
regular consumption of alcoholic beverages;
wrong technique medications;
frequent stressful situations and nervous tension.

Scientists have proven the fact that this disease can only manifest itself in people with certain character traits. So, for a person in whom certain traits do not manifest themselves under the influence of unfavorable factors, they will soon begin to develop.

It has been proven that hysteria is a condition that cannot arise abruptly; it requires a certain kind of preparation (for example, like actors, before a performance).

What does this look like in real life?

A hysterical attack is characterized by a number of different symptoms. We list the main ones:

At the same time, the following manifestations of an attack of hysteria are also observed:

the quality of vision and hearing deteriorates significantly;
a person’s field of vision narrows;
hysterical blindness manifests itself, which affects 1 or both eyes at once;
deafness (temporary);
the patient's voice ceases to be clear and sonorous (aphonia);
muteness appears;
a person begins to speak in syllables;
stuttering;
during an attack, paralysis of individual limbs or the entire body develops ();
the muscles of the tongue, neck and face become paralyzed;
bending the body in the opposite side(in the form of an arc).

A patient who is characterized by frequent hysterical seizures is characterized by the following symptoms:

refusal to eat;
inability to swallow food on your own;
vomiting and nausea (psychogenic origin);
frequent belching, coughing and yawning.
presence of flatulence;
shortness of breath, which in most cases resembles an attack of bronchial asthma.

First aid

To provide first aid in case of a hysterical attack, you must follow the following rules:

you need to try to calm down all the people around you;
after this, the patient will need to be moved to a quieter place;
it is desirable that as few people as possible be nearby;
if possible, give alcohol (ammonia) a sniff;
You shouldn't stand too close to the person, but it is important to stay at a distance so that they can see you.

leaving a person during a hysterical attack;
forcibly restrain the patient's arms, neck, legs and head;
shout at the patient.

Competent solution to the problem

The main task of treating a hysterical attack is to get rid of the reasons that provoked it. To do this, you will definitely need the help of a psychotherapist.

According to an individually designed program, he will conduct psychotherapeutic sessions, which will consist of various trainings, hypnosis and suggestion.

Also, the treatment of hysteria is accompanied by the use of psychotropic and restorative medications. They allow not only to strengthen immune system the patient, but also contribute to the normalization of his mental state.

As additional therapy, bromine preparations, Andexin, Librium, and minimal doses of Reserpine and Aminazine are prescribed.

Stopping medication or changing the dosage on your own is strictly prohibited! Drug treatment be carried out under the strict supervision of the attending physician!

Good results in the treatment of an attack of hysteria can also be achieved by means traditional medicine. They are not only absolutely safe for human health, but also help restore the vitality of the patient’s body. For example, before going to bed, it will be very useful to drink a cup of decoction based on motherwort, chamomile, mint, lemon balm or valerian.

The use of these herbs is contraindicated only in case of individual intolerance or allergic reactions.

Before you use traditional methods treatment, it is imperative to consult a specialist. It is important to find out whether these herbs are compatible with the components of the medications you are using.

Let's say no to hysteria

Prevention of a hysterical attack mainly consists in ensuring that all relatives who surround the patient show a normal attitude towards him.

This means that you should not be overprotective, because the patient may understand everything incorrectly, which will become the reason for another manifestation of a hysterical state. Walking in the fresh air and engaging in some calm and soothing activity will be helpful.

It is important to remember that a favorable and positive atmosphere must always be present in the family (quarrels and scandals can only aggravate the course of the disease).

“Throw a tantrum” or “become hysterical” - people often use such expressions, but pay little attention to what they mean. In fact, absolutely all people can be hysterical. However, a hysterical attack is attributed to neuropsychiatric disorders, which are characterized by their own symptoms. Only with the help of specialists is treatment and first aid possible.

What people call , is usually not considered such. Only externally does a person’s behavior resemble a hysterical attack. However, this phenomenon has certain characteristics and signs of manifestation, which will be discussed on the website psychological assistance website.

A hysterical attack is called a protest or provocation for the purpose of obtaining personal gain or achieving someone else's attention. Hysteria is usually attributed to women and children. However, men can also experience hysterical attacks.

Duration pathological behavior impossible to install. It lasts a different amount of time for everyone. Some are hysterical for a few minutes, others for hours. Typically, a seizure occurs during the daytime and is preceded by unpleasant experiences that arise in a person.

We can say that hysteria is a consequence of not achieving what you want. A person is indignant, indignant, worried, angry because he did not get his way. Now he's hysterical. This is one of the methods of manipulation, which should force others to do what is required of them. Why does a person get hysterical? Because he's used to it. This is how he got what he wanted before. His behavior was encouraged by other people.

Providing first aid at the time of a hysterical attack is very important. The point is that excessive nervous tension leads to a deterioration in cerebral blood supply, which can lead to a stroke or heart attack. Also, this type of seizure should be distinguished from epileptic.

What is a hysterical attack?

A hysterical attack is popularly called inappropriate behavior. However, if healthy person such behavior is truly inadequate, then the patient actually needs help. A hysterical attack is behavior of a psychoneurotic nature that occurs as a result of protest or provocation.

The person is indignant, indignant, angry, irritated. Everyone expresses these experiences differently. A person of the hysterical type resorts to hysterical attacks with their corresponding symptoms.

Hysterical attacks were also described by Hippocrates, who called them “rabies of the uterus,” attributing this disease exclusively to women. However, it has already been proven that the behavior in question is inherent in absolutely all genders and any age. It’s just that in society it is customary for a woman to be an emotional person and express her feelings in full than for a man.

Hysterical seizures are characteristic of a certain group of people:

Suggestible and self-suggestible.
Dreamers.
Unstable in mood and behavior.
Seeking to attract attention through extravagant behavior.
Those who strive for theatricality in public.

The cause of hysterical fits can be phobias, fatigue, hostility, belief in a conspiracy, etc. About 7-9% of the total population suffers from hysterical fits. Often, a hysterical personality manifests itself from childhood. If parents notice that their child is screaming excessively, arching, crying loudly and screaming, then it is necessary to show him to a pediatric neurologist.

There are often advanced cases when hysterical attacks are already habitual for a person. They are no longer manifested by a child, but by an adult. Here it is necessary psychiatric treatment, which consists of prescribing medications and conducting consultations. Most main task is to identify life circumstances that led to hysteria.

Symptoms of a hysterical attack

All people experience hysterical attacks differently. However, doctors highlight general symptoms their manifestations, according to the patients themselves:

Body trembling.
The onset of deafness, blindness and paralysis.
Erratic body movements: throwing up arms and legs, wringing elbows, clenching and grinding teeth, pulling out hair.
Bending into an arc with the whole body, while leaning on the heels and head.
Saying the same words.
Crying and screaming, laughing.
Loss of coordination.
Speech disorder.
Frequent urination, hiccups, esophageal spasm, vomiting, rapid heartbeat, belching.
Falls to the floor are sudden, but such as not to harm yourself. Then erratic, chaotic movements of arms and legs and theatrical expressiveness.
Absence of epileptic symptoms: tongue biting, discharge from the mouth, increased sweating, uneven breathing, non-fixation to light, involuntary bowel movements and urination.
Remembering what happens.
Pain in the region of the heart with tachycardia.
Feeling short of air.
Redness of the skin of the face, neck, forehead.
Closing the eyes with the inability to open them.
Cramps after falling on the floor.
Tearing one's clothes.

A person after a hysterical attack remembers everything and quickly returns or moves on to another activity, which is simply impossible after an epileptic seizure. When he achieves his goal, he enjoys it. This indicates the pretense of the situation. There is no unconsciousness here, and there is also a childish facial expression to create the illusion of misunderstanding.

Hand tremors and contraction of body muscles are the final stage. There are no hysterical attacks during sleep. Hysteria can often be accompanied by ideas about people having diseases. This develops hypochondria when the patient begins to consult doctors with fictitious symptoms.

It should be noted that a hysterical person acts rationally. She acts exactly in the way that is beneficial, useful, and convenient for her. At the same time, the actions are feigned. To some extent the person loses sensitivity. Pain appears in various parts of the body, and disorders also arise:

In the senses:
Loss of hearing or vision.
Hysterical blindness in one or two eyes.
Narrowing of the field of view.
Hysterical deafness.
Speech disorders:
Stuttering.
Dumbness.
Hysterical aphonia.
Pronunciation by syllables.
Movement disorders:
Trembling of individual parts or the entire body.
Unilateral paresis of the arm.
Paralysis.
Arching the body.
Inability to perform an action.
Nervous tics of facial muscles.
Paralysis of the muscles of the face, tongue, neck.
Disorder of internal organs:
Psychogenic vomiting.
Lack of appetite.
Dyspnea.
Swallowing disorder.
Simulation of bronchial asthma.
Nausea.
Cough.
Pseudoappendicitis.
Hiccups.
Yawn.
Flatulence.
Belching.

Hysterical seizures in children

Hysteria is quite common among children. Often they are “idols”, “favorites” in the family. Such children exhibit selfishness, suggestibility, increased sensitivity, instability of mood, impressionability, egocentrism. A hysterical attack occurs due to the child's dissatisfaction with dissatisfaction and anger. The seizure, like in adults, has a theatrical quality and lasts until the baby gets what he wants.

Rarely, hysterical attacks are accompanied by blinking and neurotic tics, whining, stuttering, and tongue-tiedness. These symptoms appear only in the presence of those people to whom they are directed, and disappear when these people leave and do not pay attention.

Parents who experience hysterical attacks frantically search for an answer to the question of what to do. Since it is important for them that the baby behaves calmly, others think of them as good parents, they are trying with all their might to calm the baby. But this is possible only if his desires are satisfied, for the sake of which the hysteria was staged. If the desires are satisfied, then the baby will think that hysteria is the only way to get what he wants from his parents, and will again resort to this method of manipulation.

How to treat a hysterical attack?

A hysterical attack occurs suddenly and develops rapidly. It causes confusion when it first appears. If it repeats day after day, then you need to contact a neuropsychiatrist or psychiatrist. How to treat a hysterical attack? This issue should be dealt with by a doctor who will first clarify the diagnosis and then decide on treatment, depending on the severity of its manifestation.

The seizure is preceded by a strong experience that develops long time. Hysteria is a consequence of incontinence of emotions. Since hysterical seizures can lead to oxygen starvation of the brain, first aid should be provided quickly.

Due to an attack when human body breathing and heartbeat are disrupted, the brain does not receive sufficient blood supply. This can lead to a stroke or heart attack. The following actions can be the first aid:

The calmness of those around them, their behavior as if nothing was happening.
Creating a peaceful environment.
Transferring a person to a calm environment.
Give ammonia a whiff.
Removing strangers from the premises.
Do not pay attention to the patient and remain at some distance from him.
Do not lose sight of the patient and do not hold his arms, head, or shoulders.

You should call a doctor if the attacks of hysteria do not go away. You can spray cold water on the patient. At the same time, it is forbidden to indulge him, as this will make him think about the correctness of his behavior.

For prevention, you can use decoctions of valerian, motherwort, and sleeping pills. The patient’s attention should not be drawn to his illness and symptoms.

Hysterical attacks first appear in childhood or teenage. They can then be smoothed out. However, if severe, hysterical symptoms may reappear in adulthood.

Results

Hysteria is common. It manifests itself in almost all children. However, over the years the symptoms smooth out. Many people completely get rid of hysteria, which happens with the help of their parents. However, the actions of parents who indulge their child can lead to a negative outcome.

Hysterical attacks are theatrical in nature. They are intended for specific people. If these people stop paying attention to them, then the seizures may disappear. However, this depends on the psychological health of the hysterical person. In some cases, seizures are part of his nature.

In psychotherapy, the state of hysteria is called a destructive disorder that can develop into severe form neurosis. People often confuse hysterical seizures with other mental disorders. But they are easier to treat than any other disorder, early stage, therefore, if such symptoms occur, it is better to consult a doctor immediately.

Causes of hysteria

Hysteria is a condition during which a person is unable to adequately behave and respond to external stimuli. This behavior is demonstrative, more often reminiscent of protest and a sharp reaction to some action of another person.

The main causes of hysteria:

Features of human development. It happens that a child is raised in difficult conditions or is overly spoiled. Then, hearing his parents contradict his desire, he falls into a state of severe hysteria.
Behavioral features. People with increased emotionality suffer from hysterical attacks. They do not know how to control their emotions, so it is easier for them to yell at someone than to adequately solve the problem.
Physical overexertion. It happens that a person has overworked, is mentally and physically tired and wants to rest, but others are putting pressure on him. He sleeps little (3–4 hours a day), eats irregularly, eats unhealthy foods, and refuses to exercise. Then he may not be able to stand it, and there will be an outburst of negative emotions.
Moral exhaustion. Hysteria can be the result of emotional burnout, nervous breakdown, or professional deformation. It often appears in women during PMS or menstrual periods, dieting or lack of self-esteem. The beginning may be a conflict, which soon develops into a serious scandal. Then a person really gives in to emotions and can start crying at one moment and be happy at another.

In addition, hysteria can be initial stage mental illness. This symptom often occurs in people with manic tendencies, panic attacks or vegetative-vascular neurosis.

Symptoms

Each person has their own characteristics of a hysterical attack, but there are common symptoms of this condition. The first significant sign is confusion. A person does not know what to do correctly at a particular moment and cannot adequately assess the situation and make a decision. Gradually, internal tension increases, and he begins to get very nervous. As a result, the following symptoms appear:

increased sweating;
low or high blood pressure;
dizziness, lightheadedness;
feeling of nausea;
muscle weakness, which may be accompanied by cramps and trembling;
inhibited reaction, etc.

The next stage of hysteria is attacks of convulsive crying, which can abruptly turn into laughter. Usually ends with loud screams, a request for help and strong crying. Sometimes a person in such a fit tries to somehow calm himself down by saying affirmations.

The last stage - a person cannot control himself, and every day begins with sobs. He sees no meaning in life, wants to fall asleep quickly and constantly gets into conflicts.

Features of hysterics in children

A child's hysteria is the result of his disharmonious upbringing. It usually develops in families where parents constantly quarrel, humiliate their son or daughter, and use physical force against him. Then such behavior is a manifestation of hopelessness. The child does not know how to behave in order to correct the situation.

Another option is that the baby is the only child in a rich family. All the attention is on him, which he quickly gets used to. In the future, any refusal or prohibition causes resistance in him in the form of screams and hysterics. The child becomes demanding.

Another case is families where there are too many prohibitions and restrictions, when the child does not have the right to choose. He wants more freedom of action, which is why hysterical attacks occur.

Typical manifestations of hysteria in children:

The presence of screaming or increasing crying. This is the initial stage.
The child hits his head against the wall. Other options are rolling on the floor, jumping a lot and strongly, knocking his feet on the floor, hitting his parents or other people around him.
The baby begins to scratch and bite others. May cause harm to oneself.
The appearance of seizures. This is the last stage. Usually manifests itself in the form of abnormal and severe bending of the body (“hysterical bridge”).

Consequences

During a hysteria, a person can be dangerous to others. He does not control his actions, acts impulsively and does everything on emotions.

If tantrums occur frequently, this may become the basis for the development of more serious mental illnesses.

The weakest among them is nervous breakdowns. This is the most common result of frequent hysterical attacks. Main symptoms:

sudden mood changes several times a day;
causeless tearfulness;
prolonged apathy;
long-term depression;
excessive anxiety;
increased fatigue;
headache;
sleep disorders (insomnia);
poor appetite, etc.

Ways to quickly stop a tantrum

It is important to learn to recognize hysteria and be able to stop it yourself. The methods are universal and consist of the following:

Don't persuade. Any persuasion or requests to calm down only aggravates the situation and irritates the patient. The actions of such a person are not always thought out; logic does not work.
Leave the premises. This is especially true for situations with children. The presence of strangers makes you want to continue the hysteria. It is better to go outside, talk to the patient and give him time to come to his senses.
Splashes of water. An excellent way to bring a person in a seizure to his senses. You need to splash a small amount of water on your face or pat your cheeks, lightly press on the painful point, etc. The main thing is to do this carefully and without much effort so as not to cause harm.
Talk calmly. In this case, it is important not to blame the person for his bad behavior and negative character traits. It is necessary to explain that since such situations happen often, you should seek help from a doctor. It is important to do this without aggression or anger, but gently and calmly.
Give me some water to drink. You can also give ammonia to smell.

If you need to stop hysterics in children aged 2–3 years, a method that will help is when the parent begins to talk to the child as if he were an adult. Explains to him why he cannot fulfill the request. Often parents say that this situation also depresses them and makes them sad, after which they present an alternative way to solve the problem. As a result, the child forgets about the offense and agrees to the proposal.

You can try to distract the baby. Ask to look out the window, show or draw something.

For children 3–5 years old, a sweet “pill” for hysterics is suitable. The point is, at the first sign of a breakdown, give the baby his favorite treat (it must be harmless, i.e. no chocolates, sweets or chips).

The easiest method is to simply hug the baby. To say that he is loved in any case, but with excessive whims he upsets his parents and makes them experience negative emotions.

Treatment options

Ordinary hysteria cannot be cured. This is only temporary and demonstrative behavior, so you need to fight the reasons that cause it. Psychotherapy will help with this: cognitive behavioral therapy, art therapy, and medication.

Cognitive behavioral therapy

Its goal is to change a person’s behavior pattern, his type of thinking. During the healing process, people learn to understand their thoughts and analyze their actions. By the end of the course, the patient should become aware of his own condition and that it can and should be dealt with.

Cognitive behavioral therapy is done with a psychotherapist or psychiatrist. At the first session, he asks the patient leading questions:

what provoked such behavior;
why I couldn’t control my emotions;
How often do such hysterical attacks of irritation and hatred and conflicts occur?
the patient is enraged by specific people or their actions, actions, manners, etc.

At this and subsequent stages, client involvement is important. If he is not interested in treatment, you should not waste your time.

The course consists of 5–10 sessions depending on the specific situation. One consultation lasts 40–60 minutes. During the process, aspects of human behavior are discussed. It is possible to attend group classes.

Treatment consists not only of individual sessions, but also of homework. The goal of the latter is to work through their problems independently. Understand the root causes of hysteria, learn to quickly recognize and prevent it. In this case, self-analysis is connected to cognitive behavioral therapy.

After each session, the adult patient is asked what he or she has learned about himself or his disorder. Often consultations take place in the form of role-playing games and active dialogue. This makes it possible to track progress and make a prediction whether the disorder will develop or this process may stop.

Art therapy

In psychology, this method of treatment is best for children from 3 to 10 years old. The idea is that with the help of some type of art you need to display your fears or hateful things. Allows you to understand why a child behaves in a certain way during a tantrum.

The colors that the child used in the drawing, all the lines and strokes, as well as ornaments are analyzed. The larger the size of the depicted object, the more clearly negative emotions appear.

After art therapy, you need to talk with your child. Ask to explain the drawing, what causes fear and provokes internal hysteria.

Art therapy will not cure hysteria. In psychiatry they believe that it only gives an idea of the nature of the problem, and psychoanalysis, hypnosis and cognitive behavioral therapy will help get rid of it. Suggestions and beliefs are used. The technique is chosen depending on the subject of hysteria.

Drug treatment

Sedatives are one of the most quick options come to your senses during a hysterical attack. They have a sedative effect. Herbal medicines will help:

valerian;
St. John's wort;
chamomile;
lavender;
oak;
motherwort;
lemon balm;
mint.

Sometimes the composition may contain B vitamins, which have a beneficial effect on the central nervous system.

For increased excitability, take bromine-based medications. If hysteria happens often - tranquilizers. They relieve emotional stress and eliminate anxiety. The best among them:

"Buspirone";
"Atarax";
"Mezapam";
"Mebicar";
"Clozepid";
"Amizil";
"Phenazepam."

If the hysteria is so strong that it leads to insomnia, you need to drink sleeping pill. Sometimes chamomile or mint tea is enough.

Prevention

There are several methods of prevention.

Breathing techniques. You need to take 3 deep breaths in and out to calm down. The best technique- combined. It involves the collarbones, chest and abdomen. The inhalation begins from the stomach, passes through the chest and reaches the collarbones. Exhalation goes into reverse order. The interval between them is 3 s. 3-5 times are enough, no more is needed, otherwise you may feel dizzy.
Affirmations. These are positive statements that work for self-hypnosis. Usually these are words like “calm down, everything will be fine, I can handle everything.” They help if a person has hysterical neurosis due to overload with work or moral exhaustion.
Physical exercise. Running, race walking, boxing, dancing, gymnastics, aerobics - there is no difference. The main thing is that the person enjoys the activity. Yoga and meditation are also considered forms of physical activity. 2-3 classes a week are enough to get rid of accumulated negative energy and stop hysteria.

Conclusion

Hysteria is demonstrative behavior that is the result of the accumulation of negative energy and moral exhaustion. The main signs are a sharp transition from sobbing to laughter, convulsions, inability to control emotions, suicidal tendencies. If you notice these symptoms, you should definitely contact a psychologist, undergo diagnosis and treatment.

How to help yourself (and your loved ones) in case of hysteria, aggression, apathy, fear, anxiety or tears. Zozhnik gives here a completely important brochure for everyone about the first psychological first aid: what to do and what not to do in these cases.

This is a system of techniques that allows people who do not have psychological education to help themselves and others who find themselves in an extreme situation cope with psychological reactions.

Finding himself in such a situation, a person experiences a strong emotional shock, because his usual “normal” life suddenly changed. Being in such a state, a person cannot always cope with the strongest emotional reactions, which overwhelm him at this moment. It is very important to support, help find strength and courage to live on.

Hysterics

Hysterical reaction – in dry medical words “an active energy-consuming behavioral reaction.” A person violently splashes out his emotions on others. He can scream, wave his arms, and cry at the same time. Hysteria always occurs in the presence of spectators.

The hysterical reaction is one of the ways in which our psyche reacts to extreme events. This reaction is very energy-consuming and has the ability to infect others.

How to help someone else when they are hysterical

Try to remove the audience and focus attention on yourself. The fewer spectators, the faster the hysterical reaction will stop.
If it is impossible to remove the audience, try to become the most attentive listener, provide support to the person, listen, nod, assent.
Talk less yourself. If you speak, then use short, simple phrases, addressing the person by name. If you do not “feed” the hysteria with provoking words and statements, then after 10-15 minutes it will subside.
After a hysteria, a loss of strength occurs, so it is necessary to give the person the opportunity to rest.

Helping yourself when hysterical

In such a state it is very difficult to help oneself with anything, because at this moment the person is in an extremely excited state. emotional state and does not understand well what is happening to him and around him.

If you have an idea about how to stop your hysterics, this is already the first step towards stopping it. In this case, you need to take the following actions:

get away from the “spectators”, be left alone.
Wash your face ice water– this will help you come to your senses.
Do breathing exercises: inhale, hold your breath for 1-2 seconds, exhale slowly through the nose, hold your breath for 1-2 seconds, slowly inhale and so on.

Unacceptable actions during hysteria

Do not perform unexpected actions (such as slapping, pouring water on, or shaking the person).
Do not enter into an active dialogue with the person about his statements, do not argue until this reaction passes.
There is no need to assume that a person is doing this intentionally to attract attention.
Remember that hysterical manifestations are a normal reaction to abnormal circumstances.
There is no need to say standard phrases: “calm down”, “pull yourself together”, “you can’t do this”, “get yourself together, you wimp”.

Aggression

An aggressive reaction or anger, anger - there are several types: verbal (when a person expresses words of threat) and non-verbal (a person commits aggressive actions).

In a situation where the usual way of life is suddenly and significantly disrupted, any person has the right to experience anger, anger, and irritation.

In such a situation, you can help a person cope with a flurry of emotions, with his anger and with dignity survive the trials that he has faced.

Anger is an even more emotionally contagious reaction than hysteria. If it is not stopped in time, then at some point it may become widespread. Many people, having experienced such a reaction, then wondered how this could happen to them.

To support a person, accept his right to this reaction and the fact that it is not directed at you, but at circumstances.

How to Help Another Person When Angry

Talk to the person calmly, gradually reducing the pace and volume of your speech.
It is important to speak softer, slower and calmer than the person who is feeling angry.
Address the person by name, ask questions that would help him formulate and understand his requirements for this situation: “What do you think would be better to do: this or this?”

How to help yourself with aggression

Try to express your feelings to the other person.
Give yourself physical activity.

Unacceptable actions during aggression

There is no need to assume that a person expressing aggression is evil in nature.
Anger is the expression of emotional pain at “abnormal” circumstances.
Don’t try to argue or convince a person, even if you think he’s wrong.
Don't threaten or intimidate.

Apathy

Apathy is a decrease in a person’s emotional, behavioral and intellectual activity.

Often, when a person finds himself in an extreme situation, it turns out to be such a difficult experience for him that he is not able to immediately realize what happened, and apathy in this case acts as psychological anesthesia.

How to help another person with apathy

If possible, allow this reaction to take place, try to provide the person with comfortable conditions so that he can rest.
If for some reason this is impossible, then it is necessary to help the person gently get out of this state. To do this, you can offer him self-massage (or help him with this) of active biological zones - earlobes and fingers.
You can give a glass of sweet tea, offer some moderate physical activity (walk, do simple exercises).
Talk to the person, ask them a few simple questions, such as “How are you feeling?”
Tell the person that feeling apathetic is a normal reaction to current circumstances.
When we allow the reaction to take place, it allows the person to understand what happened in a comfortable way.

How to help yourself with apathy

If you feel low in energy, find it difficult to get yourself together and start doing something, and especially if you realize that you are not able to experience emotions, give yourself the opportunity to rest. Take off your shoes, take a comfortable position, and try to relax.
Do not abuse drinks containing caffeine (coffee, strong tea), this can only worsen your condition. If possible, rest as much as you need.
If the situation requires action from you, give yourself a short rest, relax for at least 15-20 minutes.
Massage your earlobes and fingers. This procedure will help you cheer up a little.
Drink a cup of weak, sweet tea.
Make a few physical exercise, but not at a fast pace.
If you need to work, do it at an average pace, try to conserve your strength. For example, if you need to get to a certain place, don’t run – walk.
Don't try to do several things at once. In this state, attention is scattered and it is difficult to concentrate.
Give yourself proper rest as soon as possible.

What not to do when you have apathy

Do not “pull” a person out of this state and do not stop the course of this reaction unless absolutely necessary.
There is no need to urge a person to pull himself together, to “pull himself together”, appealing to moral standards, there is no need to say “this is not possible”, “you must now”.

Fear

Fear is an emotion that protects us from risky, dangerous actions; every person experiences it from time to time.

Fear becomes dangerous when it is unjustified or so strong that it deprives a person of the ability to think and act.

Strong manifestations of fear are also a normal reaction to abnormal circumstances.

Fear, arising once, can settle in the soul for a long time. And then he will begin to interfere with his life, forcing him to give up some actions, actions, relationships.

How longer person lives with his fear, the more difficult it is for him to fight it. Therefore, the faster a person copes with his fear, the less likely it is that it will turn into a problem that can bother the person for many years.

How to help someone else if they are afraid

How to help yourself with fear

If you are in a state where fear makes you unable to think and act, you can try a few simple techniques. For example, this could be breathing or physical exercises.
Try to formulate for yourself and say out loud what causes fear.
If possible, share your experiences with people around you - the expressed fear becomes less.
When a fear attack is approaching, you can do several breathing exercises.

Unacceptable actions

Even if you think that the fear is unjustified or absurd, then you should not try to convince a person of this with the phrases: “Don’t think about it,” “This is nonsense,” “This is nonsense.” When a person is in this state, fear is serious and emotionally painful for him.

Anxiety

The state of anxiety differs from the state of fear in that when a person experiences fear, he is afraid of something specific (travelling on the subway, a child’s illness, an accident, etc.), and when a person experiences a feeling of anxiety, he does not know what he is fears. Therefore, in a sense, the state of anxiety is more severe than the state of fear.

The source of anxiety is very often the lack of information and the state of uncertainty that is typical for any emergency situation.

A state of anxiety can last a long time, draining a person of strength and energy, depriving him of the opportunity to rest, paralyzing his ability to act.

How to help a person (or yourself) with anxiety

In case of an anxious reaction, it is very important to try to “talk” to the person and understand what exactly is bothering him. In this case, it is possible that the person becomes aware of the source of the anxiety, and then it transforms into fear. And fear is easier to deal with than anxiety.
Often a person becomes anxious when he lacks information about current events. Then you can analyze what information is needed, when and where it can be obtained, and draw up an action plan.
The most painful experience with anxiety is the inability to relax. The muscles are tense, the same thoughts are spinning in the head, so you can offer the person to do several active movements, physical exercises to relieve tension, and even better, involve him in productive activities related to the events taking place.

Unacceptable actions

Don't leave the person alone.
Do not convince him that there is no need to worry, especially if this is not the case.
Don't hide the truth about the situation or bad news from him, even if from your point of view it may upset him.

Tears

Crying is a reaction that allows a person to express overwhelming emotions in a difficult crisis situation. Everyone has cried at least once in their life and knows that tears, as a rule, bring significant relief.

When a person finds himself in an extreme situation, he cannot immediately return to normal life as if by a wave of a magic wand. He is overwhelmed with strong emotions, and tears in this case are a way to throw out his feelings.

A person must SURVIVE any tragedy, any loss. To survive means to accept what happened to him and to build a new relationship with the world. The process of experiencing cannot happen immediately; it takes some time. Emotionally, this is a very difficult time for a person.

Tears, sadness, sadness, reflections about what happened indicate that the process of experiencing has begun. This reaction is considered the best.

If a person holds back tears, there is no emotional release, and this can be harmful to the mental and physical health of the person.

Help for the victim

We need to let this reaction take place. But being next to someone who is crying and not trying to help him is also wrong.
Try to express your support and sympathy to the person. You don’t have to do this with words, you can just sit next to him and let him feel that you sympathize and worry with him. You can just hold a person’s hand; sometimes an outstretched helping hand means much more than hundreds of spoken words.
It is important to give the person the opportunity to talk about their feelings.
If you see that the crying reaction has been prolonged and tears no longer bring relief to the person, you can offer him a glass of water - this is a well-known and widely used remedy.
You can invite the person to concentrate on deep and even breathing, and do something together with him.

Help yourself when you cry

If you cry, you don’t need to immediately try to calm down, “pull yourself together.” You need to give yourself time and opportunity to cry.
However, if you feel that tears no longer bring relief and you need to calm down, then you need to drink a glass of water, then breathe slowly but shallowly, concentrating on your breathing.

Unacceptable actions

There is no need to try to stop this reaction, calm the person down and convince him not to cry.
Do not assume that tears are a sign of weakness.

Conclusion

“Everything that does not kill me makes me stronger” - this saying of the ancient philosopher most accurately describes what happens to a person experiencing psychological trauma. Crises after tragic events, the mental pain that people experience when losing a loved one is the price to pay for being human. Some people cope with this on their own, while others cannot cope with it on their own. In this case, there is nothing shameful or uncomfortable in seeking help from a specialist: a psychologist, doctor, psychotherapist.

Hysterical reactions is a series of mental, sensory and motor disorders that arise due to overstrain of the basic physiological processes in the cerebral cortex. More often they are observed in hysteria, sometimes in other mental illnesses (schizophrenia, involutive psychoses).

Etiology of hysterical attack. In the development of a hysterical attack, the leading role belongs to the action external factor, traumatizing the psyche or indirectly weakening it.

Pathogenesis of seizures in hysteria associated with the occurrence of psychogenically caused dysfunction in the cortical structures and formations of the hypothalamic-limbic-reticular complex.

Clinic (signs) of a hysterical attack (convulsions)

A distinctive feature of hysterical symptoms is theatricality, demonstrativeness of manifestations, the attack intensifies or prolongs when there is a crowd of people around the patient.

Attack begins suddenly, without an aura, against the background of a conflict situation and, as a rule, is not accompanied by a loss of consciousness (unlike an epileptic seizure), but there may also be a twilight stupefaction. Memories of the seizure and its surroundings are usually preserved, but fragmentary. The seizure lasts from several minutes to several hours and is characterized by various motor manifestations. Patients usually do not fall, but slowly sink to the floor without causing serious injury to themselves.

arise chaotic semi-voluntary movements, which at the same time are varied, complex and expressive: patients squirm, bang their heads, tear their hair, clothes, clench their teeth, tremble, roll on the floor, scream, repeat the same phrase. The appearance of a “hysterical arc” is typical, when the patient rests on the surface only with his heels and the back of his head, and the torso is bent in an arc. Control of the function of the pelvic organs is preserved. Urinary incontinence is sometimes observed, but involuntary bowel movements do not occur. The eyelids are usually tightly compressed and patients resist attempts to open them. The shape of the pupils is not changed, their reaction to light and painful stimuli is within normal limits. When you bring cotton wool soaked in ammonia to your face, you can cause a protective reaction. Characteristically frequent shallow breathing. Pronounced hemodynamic changes are usually not observed. Often, patients develop hysterical mutism (muteness), functional changes in the auditory and visual apparatus, which are manifested by the inability to perceive complex stimuli, but with the preservation of an elementary unconditioned reaction.

Others may be noted functional changes in the central nervous system: inability to walk in the absence of objective signs of paresis (hysterical paralysis); anesthesia of areas like stockings or gloves that does not correspond to the innervation zones.

Thanks to their preserved consciousness, patients are suggestible. A change in the external situation, lack of attention and interest from others can cause a gradual relief of the seizure. A seizure can be suddenly stopped by a strong stimulus (an injection, a sharp sound, splashes of cold water), which distinguishes it from an epileptic seizure, which cannot be stopped by such measures. Differentiate a hysterical attack from epileptic The absence of stereotypical repetition, sequence of development, separation of tonic and clonic phases, and tongue biting also allows this. Sleep usually does not occur after the seizure ends.

It must be remembered that hysterical reaction may manifest itself as a state of lethargy, the so-called psychotic stupor, characterized by complete immobilization and relaxation of muscles. In this case, there is no reaction to painful stimuli, the expression of suffering freezes on the face, the patients breathe heavily and noisily. Gradually, breathing becomes shallow, the pulse quickens. By appearance the patient may resemble the deceased, which is why this condition was previously called “imaginary death.”

Seizure

A seizure is the result of an uncontrollable sudden influx of electrical energy into the brain, in simple words, this is a kind of short circuit.

If even short-term convulsive seizures occur, you should immediately consult a doctor. Leading Russian doctors, luminaries of medicine, practice at the Yusupov Hospital, who will quickly determine the cause of seizures and prescribe a course. effective treatment.

Waiting and self-medication in this case is the wrong and risky choice, which over time can lead to serious and unpromising consequences.

Some seizures are very short-lived and mild in nature. However, they can go unnoticed even by those people who have them.

In many cases, convulsive seizures present a terrifying picture: a person falls to the floor, foam comes out of his mouth, legs and arms convulse.

Seizures are classified as partial seizures (which occur due to abnormal electrical activity of neurons in a specific area of the brain) and generalized seizures. Its occurrence is associated with abnormal electrical activity of nerve cells scattered in the brain.

Causes of seizures

Seizures can occur for a number of reasons. In young children, seizures may be a sign infectious diseases, in particular, the spread of the infectious process to brain cells and its membranes. They may also be a consequence high temperature bodies.

In people of any age, seizures can appear after:

stroke;
epilepsy;
traumatic brain injury;
neuroinfections;
tumors.

A separate form of convulsions is distinguished - a hysterical attack. It is most often observed in adolescents and young women. Special attention given to seizures in pregnant women. It may occur due to late severe toxicosis.

The causes of a convulsive attack are also drug or alcohol withdrawal, or rather withdrawal syndrome, as well as a change in the regimen of taking certain drugs. anticonvulsants and overdose of certain medications.

In some cases, to get rid of seizures that occur, doctors recommend patients change their lifestyle, but in most cases they still need to undergo a course of therapy.

Neurologists at the Yusupov Hospital develop a treatment regimen for each patient individually, taking into account a number of factors.

Treatment of seizures

For any seizure, regardless of its severity, you must call an ambulance.

Only an experienced doctor can distinguish a hysterical attack from a true convulsive one. In all other cases, it should be considered as possible epileptic and the patient’s condition should be taken with complete seriousness and responsibility.

First of all, the patient should be protected from injury and damage during a seizure. To do this, place a soft pillow or folded clothing under your head. You also need to place something soft under your feet and hands.

In no case should foreign objects be placed between the patient’s teeth - spoons, forks and others, since at the time of convulsions they can provoke respiratory arrest or lead to foreign body V Airways(broken dental crown and others).

If a child has a seizure, then before the ambulance arrives, it is necessary to apply a cold compress to his forehead and in the area of the right hypochondrium. It is also allowed to give the child an antipyretic drug.

Treatment of seizures at the Yusupov Hospital

At the Yusupov Hospital, patients are seen 24 hours a day, 7 days a week. Doctors will quickly and efficiently diagnose, determine the cause of seizures and prescribe a course of effective treatment. The clinic accepts patients aged 18 years and older.

After a seizure, patients require hospitalization. The wards of the Yusupov Hospital are equipped with modern medical equipment, appliances, and comfortable furniture, which makes the patient’s stay in the hospital comfortable. The professionalism of the doctors at the Yusupov Hospital allows them to “get patients back on their feet” in a short time and avoid complications and repeated convulsive seizures.

Under no circumstances should seizures be ignored; they do not go away on their own, seizures will recur more often, and the disease will begin to progress. Timely medical intervention for seizures is very important to avoid the development of severe pathologies.

You can make an appointment at the Yusupov Hospital by phone.

Recognizing an epileptic seizure

There are a number of paroxysmal syndromes that may be vaguely similar to an epileptic seizure. When a doctor directly observes a seizure, only rarely can diagnostic doubt arise in this regard. But it is not often possible to directly observe an epileptic seizure. Much more often one has to judge the nature of a seizure based on the story about it either of the patient himself or those around him, and then such doubts can often arise.

Below is a list of paroxysmal conditions that may somewhat resemble an epileptic seizure and which should always be kept in mind when making this recognition.

Hysteria. Convulsive seizures during hysteria are currently observed among our patients much less frequently than was the case before, which, of course, was the result of both the penetration of advanced socialist culture into the broadest layers of our population, and the result of a more correct view of doctors on the essence and causes of hysteria . Nevertheless, even now we occasionally see large convulsive seizures of a hysterical nature.

Not so long ago, differentiating hysterical seizures from epileptic seizures presented considerable difficulties and served as the reason for a large number of special studies. Nowadays hardly any experienced doctor Doubts may arise about the nature of the observed seizure - there are too many differences between seizures of one kind and another, explained by the fact that in one case seizures are an automatic discharge of nervous energy playing out in the motor analyzer, and in another case they are the result of a complex mental conflict in a person with pronounced imbalance of signaling systems. This is where all the differences come from.

An epileptic seizure, as we saw above, can sometimes develop in connection with a mental experience such as surprise, fear, etc., but for the most part it occurs unexpectedly and “spontaneously.” A hysterical attack is an affective reaction - the patient reacts this way to much more complex life experiences - resentment towards someone, annoyance at others, some failure in life, grief, etc.

During an epileptic seizure, consciousness is completely lost, and no contact with the patient is possible. During a hysterical attack, some contact with the patient can still be made, and when such a patient is in convulsions, he begins to beat harder if they try to restrain him. If during a convulsive seizure the patient seriously injured himself, it was certainly an epileptic seizure.

Convulsions in epilepsy are inexpressive and meaningless, just as the cry often emitted by the patient at the first moment of a seizure is inexpressive and meaningless. Convulsions during hysteria are more coordinated and expressive. These are not contractions of certain muscles, but certain actions. Instead of an unmodulated epileptic cry, a patient with hysteria during an attack expressively cries, sobs or moans.

During an epileptic seizure, the pupils lose their light reaction, which persists during a hysterical seizure. The extinction of tendon reflexes and the appearance of pathological reflexes are not observed during hysteria. Biting your tongue always indicates epilepsy. A patient with hysteria can, of course, urinate on himself during a seizure, but this happens extremely rarely.

Hysterical seizures last longer than epileptic seizures. They are also more polymorphic compared to epileptic seizures, which occur in a much more stereotypical manner.

Patients behave differently even after the seizure ends. While a patient with epilepsy comes to his senses after loss of consciousness, for the most part not immediately, but for some time is still unable to correctly navigate his surroundings and experiences general weakness and headache A patient with hysteria, waking up after a seizure, immediately returns to his normal state, and sometimes even feels some calm or relief after the nervous discharge that has occurred.

It is possible with this differential diagnosis It should also be taken into account that hysterical attacks never occur in a state of sleep and never occur if the patient is completely alone.

It has been pointed out more than once that there apparently are no strictly pathognomonic individual symptoms to distinguish these seizures from each other and that such a diagnosis should always be based on comprehensive assessment. The latter is true, although it should be borne in mind that until recently, the attribution of such clearly organic symptoms to a hysterical attack, such as, for example, loss of light reactions of the pupils, etc., was apparently based on the fact that at that time many , then still unknown variants of an epileptic seizure passed for hysteria.

In controversial cases, detection of characteristic changes in brain biocurrents outside of seizures helps resolve the issue.

If, therefore, it is for the most part not difficult to distinguish a convulsive attack of epilepsy from a convulsive attack of hysteria, then the situation changes significantly when we have before us some less common variants of an epileptic seizure, and especially manifestations of mesencephalic, diencephalic or mesodiencephalic epilepsy.

During seizures of this type, patients are usually in a clear consciousness. With fear, they notice a number of very unpleasant and difficult symptoms, such as shortness of breath, palpitations, chills, cold extremities, diarrhea and painful cramps in the different parts bodies. They usually give a natural emotional reaction to all these symptoms, often crying, rushing about, cannot find a place for themselves and ask for help. All this can easily give the impression of hysteria to an inexperienced doctor. However, with a more careful assessment, we are also able to notice in relation to these seizures that they are fundamentally different from the emotive discharges in hysteria. Tonic convulsions during mesencephalic crises do not express anything, but autonomic symptoms in diencephalic crises they go far beyond the vegetative symptoms of emotions. In addition, both meso and diencephalic seizures are completely devoid of that element of deliberate pretense, from which no manifestation of hysterical neurosis is completely free.

Sometimes it is more difficult to distinguish the state of epileptic automatism from the somewhat similar symptoms of hysteria. Such a difficulty may arise in those (rare) cases when the actions performed during epileptic automatism are not just inconsistently absurd, but develop into more formalized behavior. Thus, one of our patients with epilepsy during such conditions always tried to hug and kiss neighboring patients. Obviously, here the patient’s automatic behavior was dictated by the old temporary connections she had, and this gave the first impression of experiencing some kind of complex mental conflict. Diagnosis of such complex states of automatism is only possible in a comprehensive manner, taking into account all other features of the disease and its course.

Until recently, difficulties in diagnosing between epilepsy and hysteria led to attempts to substantiate the idea of some kind of combined or transitional form, which was called “hystero-epilepsy.” Modern clarification is fundamentally perfect various mechanisms, underlying both diseases, make, of course, the idea of such transitional forms inappropriate and the diagnosis of “hystero-epilepsy” should never be made. On the other hand, it is not so rare that there may be combinations of both diseases in the same person. It is precisely patients with epilepsy, especially if the seizure occurs in them with preserved consciousness, that can also give hysterical seizures, which are, as it were, a psychogenic imitation of their main seizures. Such combinations have been noted more than once in diencephalic and mesodiencephalic seizures. However, it was usually not difficult to distinguish real seizures from their hysterical imitation. Clarification of the basic hysterical background of the higher nervous activity of these patients, as well as the presence of other manifestations of suggestibility and hysteria in them, facilitates this diagnosis.

Fainting. Among other paroxysmal disturbances of consciousness that may be a reason for confusion with epilepsy, one should point out general vasomotor syncope (syncope). It is necessary to remember the following features: when a patient faints, he does not lose consciousness immediately, but gradually, and before losing consciousness he feels “sick” for some time, his vision becomes dark, he experiences dizziness, general weakness, nausea; during fainting, the patient’s face turns pale, the pulse becomes weak; There are no convulsions, no tongue biting, no involuntary urination during fainting. The patient comes to his senses after vasomotor fainting also not immediately, but gradually. Often, when a patient lying down after fainting raises his head, he feels ill again, his vision becomes dark, and he again has to lie down for a while, since in a horizontal position the remaining anemia of the brain does not reach such a degree.

Fainting is often provoked by bad air (smoky, unventilated room), as well as fear associated with pain, as with various medical procedures(subcutaneous injections, tooth extraction, etc.). The sight of blood in impressionable people sometimes provokes lightheadedness and can lead to fainting.

With all these features, vasomotor syncope differs sharply from disturbances of consciousness of epileptic origin.

Also, short seizures can sometimes be mistaken for epileptic discharges hypertension, so-called “cerebral vascular crises”. After dizziness or a short loss of consciousness, mild symptoms of prolapse may remain, in the form, for example, of temporary speech disturbances or temporary paresis, etc. And since such attacks can be repeated in some cases, this, naturally, may lead the doctor to think about seizures focal epilepsy. These conditions differ from epileptic seizures, in addition to the presence of significant arterial hypertension, also by the persistence of interictal residual symptoms.

Seizures of loss of consciousness, sometimes with convulsions, developing due to brain anemia in Adams-Stokes syndrome, differ from epilepsy in the presence of a sharp disturbance of mid-vascular activity (bradycardia, transient ventricular fibrillation due to atrioventricular block).

Various variations of the so-called intention seizure, or Rülf syndrome, may also have some similarities with an epileptic seizure. These are peculiar, short convulsive discharges provoked by an unprepared active movement. Such patients must therefore very carefully and gradually begin any new movement, especially after the previous resting phase. In this case, the convulsive seizure itself can be either more cortical or more subcortical in nature. In the first case, a spasm, starting from a muscle group that has entered an active state, then spreads to adjacent segments, following the contiguity of the cortical fields and in this respect resembling a Jacksonian-type spasm. In the second case, the spasm immediately spreads more diffusely, resembling motility in athetosis and differing from athetosis only in that the process occurs here in the form of individual paroxysms associated with active innervation.

Consciousness during an intentional convulsion, unlike an epileptic seizure, is never impaired. A peculiar difference is that intentional spasm usually bothers patients very little, who, having adapted to their defect, often cope well with the demands of everyday life.

The pathophysiological basis of this peculiar syndrome differs significantly from the mechanism of epileptic discharge. It is here that, along with the increased excitability of the motor analyzer, the lack of concentration of the excitatory process clearly comes to the fore. In these patients, the process of surrounding the working sections of the motor analyzer with negative induction occurs very slowly, and they require some time for the focus of excitation in the cerebral cortex to be well demarcated and for the excitation from this focus not to spread to adjacent sections. It should be said that diagnosis of epilepsy can present certain difficulties in these cases, especially since in some cases an intentional spasm can be combined, for example, with epileptic seizures that occurred in childhood.

In some cases, the reason for possible confusion with a convulsive epileptic seizure may be the conditions of early contracture developing in severely organic patients, if they occur in the form of separate short attacks. Such short convulsive paroxysms can closely resemble the seizures of mesencephalic epilepsy described above. The fundamental difference between these conditions can be that such a convulsion is essentially a spontaneously occurring protective reflex spasm and that with it one can always detect a massively developed syndrome of protective reflexes, which is in no way characteristic of convulsions of an epileptic nature.

The so-called effort dystonia deserves special mention. This syndrome, which has not yet been fully studied at present, consists of short but very massive convulsive installations of the type torsion dystonia, occurring with every attempt by the patient to make any movement, and here it is no longer required, as was the case with an intention spasm, that the movement be emergency or unprepared. For example, the patient wants to raise his arm, but instead a tonic flexion spasm of the trunk muscles occurs, etc.

This syndrome has been described in extrapyramidal movement disorders. The sudden development of such a widespread tonic spasm may somewhat resemble tonic variants of an epileptic seizure, but a closer study of this hyperkinesis immediately reveals its connection with active innervation and, therefore, a completely different mechanism of origin.

In the same way, other paroxysmal seizures in extrapyramidal syndromes should be strictly distinguished from epilepsy. This includes numerous types of paroxysmal hyperkinesis that occur in the chronic phase of epidemic encephalitis, of which the so-called “gaze convulsion” is the most common. These are characteristic “violent movements”, the difference of which from epilepsy we spoke above when discussing the problem of so-called “subcortical” or “striatal” epilepsy. The so-called “facial paraspasm”, which usually develops against the background of either cerebral arteriosclerosis or a history of encephalitis, also has nothing in common with epilepsy, although it can manifest itself in the form of separate convulsive paroxysms, separated from each other by relatively light intervals. Common phenomena of the so-called “paradoxical kinesia” (the appearance and disappearance of spasms in special conditions motor skills), often found in facial paraspasm, easily allow
distinguish these forms of hyperkinesis from epileptiform states. These conditions are described in more detail in the section “Local convulsions”.

It is easy to distinguish the so-called facial hemispasm from focal forms of epilepsy, although recently attempts have been made to combine these diseases. However, these attempts (for more details, see the corresponding section) were apparently based on the fact that they were based on not entirely pure cases of facial hemispasm. Pure cases of this syndrome have a clearly different, non-epileptic origin: they are distinguished by strictly consistent locality peripheral type, after each convulsive discharge they do not leave paresis, do not detect characteristic changes in brain biocurrents and are not amenable to antiepileptic therapy.

Nocturnal epileptic seizures, especially in children, sometimes give rise to confusion with nocturnal enuresis. The fact that if a child suffering from enuresis urinates in bed at night can help in recognizing these syndromes, he wakes up completely healthy in the morning, sometimes feeling only natural awkwardness from what happened. On the contrary, after an epileptic seizure that occurred in a dream, the patient wakes up in the morning exhausted and with a headache.

In the same way, one should distinguish between attacks of ordinary neurotic sleepwalking and attacks of epileptic automatism, as discussed above.

Attacks of so-called static epilepsy can have very great similarities with attacks of cataplexy, especially since we often do not observe them directly, but only know about them from the stories of the patients themselves or those around them.

To distinguish these attacks from each other, it is important to remember that attacks of cataplexy are usually directly provoked by some (usually pleasant) emotion, and also that patients suffering from cataplexy, as a constant rule, also simultaneously experience episodic sleep in the form of characteristic attacks narcolepsy. In addition, an attack of static epilepsy lasts for the most part shorter than an attack of cataplexy.

It is usually not difficult to distinguish attacks of epileptic sleep from narcoleptic seizures: attacks of epileptic sleep are much longer, while the sleep itself is much deeper.

In cases where an epileptic seizure begins with a vestibular aura, and such an aura can appear in isolation, naturally, sometimes a very difficult question arises about the difference between these conditions and attacks of Meniere's vertigo. Diagnosis can often only be complex, taking into account other signs of epilepsy. One of the diagnostic signs, apparently, can be the fact that dizziness during epileptic vestibular aura does not depend on one or another position of the head and is not accompanied by such strong autonomic repercussion as during angioneurotic vestibular crises.

An epileptic seizure differs from a migraine attack in the following ways: a large number signs that, it would seem, diagnostic difficulties should not arise here. However, in a number of observations it turns out that some manifestations of the so-called associated migraine may closely resemble epileptic auras.

For example, pre-ictal hemiparesthesia or scotomas during migraine can give rise to confusion. One of the good differential diagnostic signs can be the different speed of symptom generalization in these conditions: a migraine focal symptom spreads across the cortex much more slowly. Thus, it was indicated that migraine paresthesias that began, for example, in the arm, require tens of minutes to spread over the entire half of the body, while a similar syndrome in Jacksonian epilepsy develops much more quickly. The slowness with which migrainous atrial scotoma spreads across the visual field is also well known.

In some cases, certain diagnostic difficulties may still arise. Thus, Kissel, Arnoux and Hartmann recently described an observation of a girl who, during her menstruation, experienced either migraine attacks or epileptic seizures, both of which were preceded by the same visual aura. It is remarkable that the same aura could be observed in her in isolated form. In this regard, one can also recall the observation of Shavani, in which attacks of ophthalmic migraine and epilepsy with visual aura alternated.

All these individual elements of similarity between both diseases are probably explained by the fact that although the immediate mechanism of the appearance of both diseases remains unknown to us, nevertheless, there is obviously some pathogenetic relationship between them. This is evident at least from the frequency of secondary cases of migraine in families from which patients with epilepsy come, as well as from the relatively high frequency of a combination of epilepsy and migraines in the same person. The relationship of both diseases is confirmed pharmacologically. Thus, it turned out that in the presence of migraine, the smallest dose of Cardiazol is enough to cause an epileptic seizure.

Finally, it should be borne in mind that attacks of a special state of consciousness can also give rise to diagnostic errors. Namely, somewhat similar conditions can be observed in neuroses. These are short-term and usually completely identical disturbances of consciousness, sometimes occurring in those suffering from neuroses, each time under the influence of some stereotypical external cause. Such reasons include various situations that require either a very strong concentration of attention or a very rapid transition of attention from one thing to another. This is, for example, the need to urgently switch attention in some new direction, sometimes in conditions of decreased cortical tone, or the need to fix attention in several directions simultaneously, or simply the presence of a negative emotion. In such cases, patients speak of “numbness”, or “inhibition”, “freezing of thought”, “remoteness”, etc., that is, they use definitions very close to how patients with epilepsy describe their special conditions. Probably, these conditions are based on pathological irradiation of the inhibitory process through the cortex due to the weakness of internal inhibition.

These conditions, which have not yet been sufficiently studied, are often mistakenly considered to be a manifestation of epilepsy. They differ from epilepsy in a number of very significant characteristics.

Thus, these conditions always develop with a clear reason, which includes a typical neurosogenic situation, namely: overstrain of nervous processes or their mobility. Further, these patients do not show other signs of epilepsy, but constantly display a number of other neurasthenic symptoms. It is also not possible to detect changes in the biocurrents of the brain characteristic of epilepsy in them. Antiepileptic treatment does not help them either, but therapy aimed at combating neurosis often brings them significant relief.

These “special conditions” of a neurotic nature should therefore always be remembered in order to avoid unjustified overdiagnosis of epilepsy.

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