Disorientation: What is it? (Symptoms, Causes, Treatment)

Medical classification

Disorientation is classified into radiation, occupational, spatial and social symptoms. Psychiatry identifies the term “autopsychic disorientation” - the lack of perception of personal factors (the inability to reproduce the last name, first name, patronymic, date of birth, that is, identification data). With this phenomenon, the individual’s surrounding world changes, and orientation in it is completely absent. A double perception of the world is noted, a real and imaginary environment is created, alternately visited by the psychological inner world. The full picture emerges after a proper examination by a doctor.

Pathogenesis

Successful navigation in space requires sufficient development and preservation of cognitive activity, including perception, recognition of spatial landmarks, discrimination between the left and right sides of the body, mental representation of space, and spatial memory. Visual information is processed in the primary projection zones of the occipital cortex, then goes to the posterior convexital parietal regions, the lateral surface of the temporal lobe, which ensures the recognition of objects and determination of their location.

The prefrontal cortex is responsible for short-term spatial memory and regulatory functions that implement human movement in space. Thus, the pathogenesis of disorientation is based on a violation of the cognitive component, a pathological change in the activity of brain structures that provide visual-spatial gnosis, mental representation of space, and topographic memory.

Diagnostics

If you have such a symptom, you should consult a neurologist or psychotherapist. First of all, the doctor conducts a physical examination of the patient to determine complaints, life history and illness. To make an accurate diagnosis, the following laboratory diagnostic methods can be used:

blood sampling for general and biochemical studies;
test for the presence of narcotic substances in the body;
CT and MRI of the brain;
psychotherapeutic tests.

The exact diagnostic program will depend on the current clinical picture and general condition of the patient.

Basic therapy will depend on the diagnosis. In general, treatment interventions may include the following:

providing rest to the patient;
elimination of stress, excessive emotional stress;
care.

As for drug therapy, it may include taking the following drugs:

tranquilizers;
antidepressants;
sedatives;
hypnotic;
neuroleptics;
vitamin and mineral complexes.

The dosage, regimen and duration of taking medications should be prescribed only by the attending physician. You cannot take such drugs without permission.

Identity structure according to E. Erikson

The psychoanalyst identifies four components of identity, which in symbiosis form the overall structure:

Uniqueness of personality. The ability to recognize one's individuality and experiences, which distinguish a person as a separate social unit.
Integrity. A person’s feeling of meaningfulness, identity and coherence with his existence. Integrity provides a connection to past experiences that carry over into the present and shape the future. Thus, a person understands what he was and what he wants to become.
Unity. Internal harmony of the personality, which is formed from childhood images transferred into adulthood.
Social solidarity. A person’s support for the ideas of a particular community. Expectation of approval and support from the referent group.

If all these elements in the personality structure develop harmoniously, overcoming crises occurs with relative ease and productively.

3) Graveyard Spiral

0
As the name suggests, the mourning spiral is not a good thing. If left in a reversal position long enough, the fluid in the inner ear will stop moving. When you return to straight flight, you will feel like you are turning in the opposite direction and will return to the original turn. Due to the fact that the plane loses altitude while turning, if you do not move the control stick, it will begin to descend. Because you think you are in a descent, you reach for the helm. But in reality you are in a contracting spiral turn and losing more altitude. How to prevent: Strictly adhere to the attention distribution scheme, avoid delaying attention on any one device.

Benefits of diagnostics

Timely detection of disorders contributes to rapid recovery, absence of consequences and progress towards a complete change in the condition for the better. Due to the fact that the signs of this disorder very often accompany similar disorders, sensible people will not put off visiting a psychotherapist in order to alleviate the fate of their loved ones who find themselves in a difficult situation.

The examination is performed by a psychiatrist or neurologist. Identifying disorientation and establishing its causes is important for objectifying the severity of functional limitations of activity in brain pathologies, determining the nature of confusion in psychotic states, alcohol or drug intoxication. Such an analysis of the symptoms of disorientation is necessary for the differential diagnosis of focal organic pathologies and neurodegenerative diseases, psychoses of various etiologies. The main research methods are:

Clinical survey. At the first diagnostic stage, the doctor clarifies the symptoms, specifies their severity, duration, the presence of neurological diseases, mental disorders in the patient and his relatives. When disorientated, patients report that they cannot independently get to their usual places (hospital, store), and are unable to find their way back to home. They do not use landmarks and do not know how to use routes.
Neurological examination. The clinical and neurological status of the patient is assessed, the presence of focal and cerebral symptoms is determined. Neurological tests reveal the ability to determine the left and right sides, the position of objects, and one’s body in space. Patients with disorientation perform tasks with errors and answer questions after a pause.
Neuropsychological examination. The use of special tests makes it possible to analyze the structure of the deficit that forms the basis of disorientation. Topographic memory, perception of spatial relationships between objects, and preservation of the egocentric representation of space are studied. The type of disorientation and its severity are determined by the nature and frequency of errors.

1) The illusion of a roll (The Leans - lit. “Tilts”)

0
It seems that you are flying straight, but in fact you are banked. The illusion of a bank occurs if you very slowly enter the plane into a banked turn. For example: if you very slowly create a left bank and accordingly enter the car into a left turn, the fluid of the inner ear will not change position - the brain will “think” that you remain in straight-and-level flight. If you now quickly correct the position of the wings, your inner ear and brain will “think” that you have created a roll in the opposite direction (to the right). This will lead to the feeling of having to create a left bank or tilt your body in that direction in order to fly “straight” again. If, while flying in the clouds, you find yourself pressed close to the instructor, there is a chance that you have “caught” the illusion of a roll. How to prevent: The best way to prevent it is to avoid extremely slow rolls in the clouds. You should not control the machine too much, but you must be sure that the control inputs are adequate to the situation.

What causes disorientation?

Disorientation can be a symptom of various diseases

It's important to look for other symptoms that accompany confusion

Delirium and dementia

Two common causes of confusion are delirium and dementia.

Delirium is caused by a sudden disruption of brain function. It only lasts for a short period. It can be caused by medications, infections, and injuries.

Something as simple as a change in environment can also cause delusions. For example, some adults may experience hospital delirium after surgery or after intensive care.

Three types of delirium:

hyperactive
hypoactive
mixed

Hyperactive delirium can cause hallucinations and agitated behavior. Hypoactive delirium can cause drowsiness and withdrawn behavior. Mixed delirium can cause both types of behavior.

Delirium is characterized by:

decreased thinking skills, poor attention, hallucinations, abnormal speech behavior or content

Delirium often comes on quickly, resolves within days or weeks, and is variable in nature.

On the other hand, dementia develops more slowly than delirium. It is usually persistent and causes ongoing symptoms. Confusion and short-term memory loss may be some of the early signs of dementia.

Family members can play an important role in helping your doctor diagnose delirium and dementia.

Substances

Confusion can be a side effect of certain substances, including:

alcohol
marijuana
prescription drugs

Withdrawal from certain medications can also cause confusion.

Other reasons

The following physical disorders may cause confusion:

amnesia
carbon monoxide poisoning
cerebral arteritis, or inflammation of the arteries in the brain
liver cirrhosis and liver failure
central nervous system infections such as encephalitis or meningitis
complex partial seizures
shake
dehydration
drug overdose
abnormalities in the electrolyte
epilepsy
fever
heat-related illnesses
hypoglycemia or hyperglycemia
hypothermia when the temperature drops below 35°C
hypothyroidism or hyperthyroidism
hypoxia or decreased oxygen supply
mass brain lesion such as a tumor or hematoma
mitochondrial disease
orthostatic hypotension
renal failure
Reye's syndrome
sepsis
stroke
vitamin deficiency
vestibular disorders that affect the inner ear

An emergency may also cause stress or mental distress and confusion.

What to do if someone is disoriented?

You should seek medical attention for someone who is disoriented.

If someone is trying to cope with confusion, including delirium, the following may be helpful:

Keep track of his medical history. Make sure you have a list of all medications your loved one has taken. Your knowledge of his habits, medical history and symptoms can help the doctor make a diagnosis.
Try to make the environment familiar. Changing the usual state of affairs can cause disorientation. Objects that remind your loved one of who they are can help restore direction.
Stay nearby. Your presence can provide reassurance and comfort. Getting to know the person will also help the doctor determine what their normal behavior is.

You should encourage those who are disoriented to seek medical help. Call 911 if they are at risk of harming themselves or others.

Treatment

Before prescribing therapy, it is necessary to undergo a full examination. Therefore, first of all, you should visit a neurologist who will examine the individual, get acquainted with the complaints, find out the anamnesis and history of the disease.

In order to diagnose the presence of the described disorder, a biochemical blood test, an analysis to determine alcohol-containing substances or identify narcotic substances in the body, computed tomography, various psychotherapeutic tests, electrocardiographic studies, and determination of metabolic failures can be carried out.

Basic therapeutic tactics are determined by the diagnosis, since the methods of treating disorientation are directly determined by the etiological factor. If a sudden feeling of loss of orientation appears, it is recommended to try to relax, streamline the flow of your own thoughts, sometimes you even need to write them down. It is necessary to become aware of the perceived manifestations and understand what gave rise to this state.

So, for example, a decreased concentration of sugar can provoke disorientation if the last meal was taken several hours ago. To correct the situation, you should have a snack or drink a drink containing caffeine. If the described disorder is caused by dehydration of the body, it is necessary to drink water accordingly or drink a liquid containing electrolytes.

In general, the therapeutic strategy contains the following measures: ensuring peace, proper care, eliminating the effects of stressors, excessive emotional stress.

Drug therapy is based on the prescription of such categories of drugs as antipsychotics, tranquilizers, antidepressants, vitamins, sedatives, hypnotics, and mineral complexes. The selection of the required dose, duration and regimen of administration is determined by the doctor. Unauthorized prescription and use of pharmacopoeial drugs is not permitted.

Among the preventive measures, the following are distinguished:

– restriction in the consumption of alcoholic beverages;

– balancing the balance of healthy sleep and periods of wakefulness;

– balancing the diet, the foods consumed must contain the required concentration of minerals, vitamins, fiber, while foods containing “bad” cholesterol should be avoided;

– maintaining control over sugar levels in the presence of diabetes;

– getting rid of tobacco smoking.

In addition to the methods listed above, it is also important to devote time to mental exercise every day. The brain, as well as other organs, also needs training to maintain its performance.

Memorizing poems is considered a useful exercise. Daily walks also help to normalize the condition and minimize the occurrence of mental fog with manifestations of disorientation.

Psychoneurologist Hartman N.N.

Doctor of Medical and Psychological

The information presented in this article is intended for informational purposes only and cannot replace professional advice and qualified medical care. At the slightest suspicion of disorientation, be sure to consult a doctor!

Disorientation is a disorder of consciousness, as a result of which a person is unable to identify his social affiliation, personality, or navigate in time and space.

This condition is dangerous due to the loss of the ability to make decisions independently. The person does not remember people or places, times and dates.

Symptoms of spatial disorientation

The following types of personal disorientation are distinguished: radiation, spatial, professional and social disorientation.

Psychology offers the following classification of orientation disorders:

– autopsychic (which is a false recognition of oneself as a person or an absolute loss of self-identification);

– allopsychic (loss of orientation in the environment);

– double (the patient simultaneously or alternately resides in reality and imaginary reality);

– mixed or total disorientation.

A doctor can determine the state of disorientation only after conducting an examination.

Common clinical signs include symptoms such as sudden mood changes, dizziness, dream disturbance, and memory impairment.

Disorientation in space is often observed along with an inability to determine time. In addition, the disease in question may be accompanied by such manifestations as the subject’s inability to recognize himself as an individual, name the month, current year, country of residence or place of residence, and passport details.

A feeling of fear and anxiety also arises without an obvious reason. Apathy can suddenly give way to an attack of aggression. Therefore, it should be taken into account that the described state of the subject is often unsafe both for the person suffering from disorientation and for those around him. That is why, if the listed signs occur, a person should be immediately transported to a medical facility.

Social disorientation, as a rule, is not characterized by the presence of pronounced manifestations of a mental disorder. However, the following specific symptoms may occur. So, for example, the subject cannot tell his exact age. He also does not know his own social identity. In an unfamiliar environment, a feeling of uneasiness arises.

In the presence of VSD, spatiotemporal disorientation may be accompanied by: dizziness, ringing in the ears, nausea, partial hearing loss, headaches, and fluctuations in blood pressure. This condition poses a threat to the life of the individual. Self-medication or ignoring the described symptoms can lead to serious consequences and can also be fatal, since pressure surges can cause a stroke or provoke a heart attack.

Disorientation in space is a frequent accompaniment of twilight clouding of consciousness. Characterized by a sudden appearance and an equally sudden disappearance. The subject retains the ability to reproduce mechanical actions.

Loss of orientation in space: reasons

If confusion occurs, a person needs to sit down, try to calm down and relax.
It is important to remember what exactly could have caused such a condition (trauma, medication, illness, long-term and strict diet). You can write down your experiences. Confusion after a head injury is an alarming symptom that may be a sign of a concussion or more serious problems.

If loss of orientation has become a side effect of taking medications, then it is necessary to reduce the dosage selected for treatment or replace the drug with another drug.

If the reason is uncontrolled adherence to a strict diet, then it is recommended to eat something and your health will improve very quickly. In the future, it is necessary to review the diet to prevent the occurrence of more serious problems.

Disorientation combined with slurred speech and weakness in the limbs is a sign of stroke or coronary artery disease.

Confusion in the presence of a high temperature indicates a severe infection or a complication of an existing pathology. If the cause of the disease is unclear, then a comprehensive examination is necessary to clarify it.

In all cases of disorientation, examination and consultation with a qualified specialist is required, and, if necessary, medical assistance.

The main method of diagnosis for disorders of consciousness is an oral interview by a psychiatrist. General and biochemical blood tests, urine tests are also performed; MRI, screening for metabolic disorders, CT scan, and electrocardiogram may be prescribed.

When a diagnosis is made, an individually selected set of treatment procedures is prescribed. It is very important to eliminate all causes that may provoke disorientation.

With dementia in old age, it is important to provide the patient with proper care. The patient develops a whole complex of symptoms: disturbances in motor function, thinking and speech, loss of awareness of his own personality. A person needs to be in a quiet and comfortable environment. It must be constantly monitored and ensured safety.

If prolonged disorientation is noted, the patient should not be left alone. Having gone for a walk, such a person may not return home. In the event of a short-term loss of oneself and the surrounding environment, the person must be surrounded by objects that remind him of the time and date (calendar, clock).

You may need to take antidepressants. Monitoring blood pressure and pulse is necessary, and it is important to drink enough fluids.

If a child has severe social disorientation, parents should definitely consult a psychologist. He will tell you how to adjust behavior in order to improve the adaptation period in the new environment.

Preventive measures are: minimizing stressful situations, giving up bad habits, balanced nutrition, good sleep. To prevent memory changes in people of the older age group, you need to lead an active lifestyle, train your memory and thinking.

Disorientation is a formidable symptom of serious disorders. It is physiological only in children in certain circumstances. A progressive process in an adult without appropriate therapy can destroy the personality.

Disorientation is the inability to identify one’s own personality, the place of its physical location, the period in which it resides or its social affiliation. Personal disorientation often occurs as a result of damage to the structural elements of the brain.

In addition, the deviation in question often arises as a result of excessive consumption of alcohol-containing liquids, the use of narcotic substances or potent pharmacopoeial psychotropic drugs. In other words, disorientation is a disorder of consciousness.

In the described state, it is difficult for the subject to think quickly, perform actions, and there are difficulties with self-definition and orientation.

The described disorder is a change in consciousness that does not allow the individual to think clearly and quickly, in addition, it causes a loss of the ability to recognize people or distinguish places, remember time and memorable dates. Disorientation often leads to clouding of consciousness and the inability to make independent decisions.

There are many reasons that provoke the deviation in question. For example, it can be caused by organic damage to brain structures or metabolic disruptions. In older people, loss of orientation and mental fog are often caused by senile dementia.

In addition, there are diseases accompanied by disorientation.

Incoherence of consciousness can occur due to hypoxemia, observed with pulmonary diseases, with serious infectious processes, malnutrition, due to dehydration.

Incoherence of consciousness also manifests itself due to the influence of a number of external circumstances, such as hypothermia or heat stroke.

Diseases accompanied by disorientation can be identified as Alzheimer's disease, hydrocephalus, spastic pseudosclerosis, tumor formation in the brain and a disorder of its blood supply, dementia, autism, hypoglycemia, depressive states, fatty hepatosis, psychotic disorder of the body, Angelman syndrome, portal hypertension, renal failure , anxiety disorders, schizophrenia, meningitis.

In addition to the listed ailments, excessive consumption of alcohol, drugs, and dehydration can cause a feeling of personal disorientation.

Social disorientation can occur as a result of a sudden change in life. In children, loss of social orientation is the norm, since the little ones are not yet able to recognize their occupation or their own gender. It is difficult for them to navigate among new faces.

Only at the puberty stage does the time of absolute social orientation come.

The following types of personal disorientation are distinguished: radiation, spatial, professional and social disorientation.

– autopsychic (which is a false recognition of oneself as a person or an absolute loss of self-identification);

– allopsychic (loss of orientation in the environment);

– double (the patient simultaneously or alternately resides in reality and imaginary reality);

– mixed or total disorientation.

A doctor can determine the state of disorientation only after conducting an examination.

Common clinical signs include symptoms such as sudden mood changes, dizziness, dream disturbance, and memory impairment.

A feeling of fear and anxiety also arises without an obvious reason. Apathy can suddenly give way to an attack of aggression.

Therefore, it should be taken into account that the described state of the subject is often unsafe both for the person suffering from disorientation and for those around him.

That is why, if the listed signs occur, a person should be immediately transported to a medical facility.

Social disorientation, as a rule, is not characterized by the presence of pronounced manifestations of a mental disorder. However, the following specific symptoms may occur. So, for example, the subject cannot tell his exact age. He also does not know his own social identity. In an unfamiliar environment, a feeling of uneasiness arises.

In the presence of VSD, spatiotemporal disorientation may be accompanied by: dizziness, ringing in the ears, nausea, partial hearing loss, headaches, and fluctuations in blood pressure.

This condition poses a threat to the life of the individual.

Self-medication or ignoring the described symptoms can lead to serious consequences and can also be fatal, since pressure surges can cause a stroke or provoke a heart attack.

Treatment

Basic therapeutic tactics are determined by the diagnosis, since the methods of treating disorientation are directly determined by the etiological factor.

It is necessary to become aware of the perceived manifestations and understand what gave rise to this state.

In general, the therapeutic strategy contains the following measures: ensuring peace, proper care, eliminating the effects of stressors, excessive emotional stress.

Search by alphabet

traumatic (consequences of penetrating traumatic brain injury);
in case of brain injury (organ tissues are highly sensitive);
the occurrence of an aneurysm (an enlarged blood vessel affects neighboring tissues);
mercury poisoning;
increased dose of alcohol in the blood;
drug intoxication;
effects of neurotropic gas on the respiratory system;
entry of organophosphorus compounds into the digestive system;
poisoning with neurotoxic substances – puffer fish, mushrooms, carambola;
hyperthermia resulting from infectious diseases;
pain shock during a fracture, dislocation, significant blood loss;
severe diseases - tuberculosis, encephalitis, diabetes mellitus, all types of hepatitis, acquired human immunodeficiency syndrome at the final stage of development;
progression of tumor growth at the last cancer stage (intoxication occurs during the process);
ischemic disease, all types of strokes, occurring both unnoticed and obvious;
myocardial infarction, with pronounced pain and impaired blood flow;
vegetative-vascular dystonia – vasodilation occurs in areas of the body’s autonomic system;
age-related diseases: senile dementia, Alzheimer's disease, marasmus of all types;
bright emotional outburst;
hypothermia;
a period without sleep for a long time;
oxygen starvation;
1st and 2nd degree stunning.

Epidural hematoma
Subdural hematoma
Cerebral infarction or intracerebral hemorrhage
A brain tumor
Brain abscess

Brainstem infarction
Brain stem tumor
Hemorrhage in the brain stem
Hemorrhage into the cerebellum
Brain stem injury

Trauma (concussion, brain injury or bruises)
Anoxia or ischemia (syncope, cardiac arrhythmia, pulmonary infarction, shock, pulmonary failure, carbon monoxide poisoning, collagen vascular disease)
Epilepsy
Condition after an epileptic seizure
Infections (meningitis, encephalitis)
Subarachnoid bleeding
Exogenous toxins (alcohol, barbiturates, glutethimide, morphine, heroin, methyl alcohol, hypothermia)
Endogenous toxins and metabolic disorders (uremia, hepatic coma, diabetic acidosis, hypoglycemia, hyponatremia)
Psychomotor status epilepticus

How to get rid of disorientation and confusion?

If the diagnosis is established, comprehensive treatment of the underlying disease is carried out

It is important to stop all medications and ensure that there are no factors that could trigger confusion.

It is important to remember that loss of orientation in space can lead to the patient simply getting lost. It is also necessary to ensure maximum patient safety

If necessary, mechanical aids can be used. A person who has senile dementia - a disease of loss of orientation in time and space - should be in the most calm and friendly environment possible.

If the patient has only temporary loss of orientation, it is advisable to always keep a calendar and watch next to him. If possible, the patient should be constantly looked after by a nurse or one of the relatives. Depending on the patient’s condition, the doctor allows him to sit, walk, or go outside.

Sometimes patients with confusion are prescribed antidepressants.

It is important to constantly monitor blood pressure, pulse, and prevent dehydration.

If a person becomes confused suddenly, they should immediately consult a doctor. For example, disturbances of consciousness can suddenly appear in diabetes mellitus if the blood sugar level drops sharply.

As measures to prevent disturbances of consciousness and orientation, it is advisable to adhere to the principles of proper nutrition, not abuse alcohol, and regularly get enough sleep. Patients with diabetes need to constantly monitor their blood sugar levels. Elderly people should take the medications prescribed by the doctor

To prevent senile dementia, it is important to lead an active life whenever possible and be sure to train your memory and brain

Dizziness

The first thing you need to do is answer all the doctor’s questions as honestly as possible: is this the first time you’ve had this, have you had any injuries, are you on any strict diet, have you previously been diagnosed with any neurological disorders. The doctor will prescribe a series of tests and studies, such as MRI or ultrasound, to most accurately diagnose the cause of loss of orientation in space. And this will be the basis for prescribing treatment.

If the symptoms are neurological, then treatment usually begins with ensuring complete rest for the patient. It is necessary to isolate it from surrounding stress and nervous stimuli and provide it with proper care. Next, prescribe medications: antidepressants, sedatives, antipsychotics, vitamins. Let us remind you that all this is taken strictly in accordance with the doctor’s recommendations; you absolutely cannot calculate the dosage and frequency of administration on your own! Otherwise, the situation may only get worse.

If confusion is caused by external factors, such as a head injury, it is necessary to check whether it is a symptom of, for example, a concussion. If the problem is the wrong diet, you need to eat something high in calories and high in glucose. If this is due to taking medications, change the drug to an analogue or just something else and be sure to monitor the body’s reaction to taking it.

If this is the body’s reaction to alcohol, then it is better to refrain from drinking it completely, otherwise next time the consequences could be much worse. And take vitamins that strengthen the walls of the blood vessels in the brain. Which ones exactly - check with your doctor or pharmacist at the pharmacy. If there is an infection, confusion may be caused by a high fever.

In any case, so as not to cause loss of orientation in space, remember: a doctor and only a doctor can prescribe the correct treatment for you. Self-medication not only may not help, but can also be extremely destructive for your body.

Disorientation

Disorientation in space can be both a consequence of neurological diseases and their symptom. If we talk about the reasons for this phenomenon, then first of all let’s figure out what it is.

Disorientation in space is usually also accompanied by temporary disorientation, that is, at such moments a person cannot understand where he is and what day or even year it is. This condition is dangerous both for the person himself and for others.

After all, loss of orientation in space is often accompanied by an attack of panic, and in this case it is difficult to say what a person is capable of.

Causes

What could be the reason for the loss of disorientation in space? There are several of them:

Alzheimer's disease;
meningitis;
renal failure;
hypothyroidism; schizophrenia;
hydrocephalus;
epilepsy;
Creutzfeldt-Jakob disease;
manic-depressive disorders;
encephalitis;
hypoglycemia;
brain tumors and cysts.

Note that the causes of disorientation can be not only this kind of illness, but also:

alcohol abuse;
taking drugs or certain medications (tranquilizers, antiallergic drugs, painkillers, anti-inflammatory drugs, muscle relaxants);
hypovitaminosis;
dehydration;
hypothermia;
heatstroke;
traumatic brain injury;
infection;
metabolic disorders;
post-traumatic psychosis.

With improper nutrition, namely: insufficient intake of nutrients into the body, the brain begins to starve just like the body. Confusion and low blood sugar levels, and as a result, disorientation in space, are some of the consequences of improper diets.

In any case, and regardless of the reasons for the occurrence of such a condition, you should first contact a neurologist. Only a doctor, by conducting an examination and prescribing tests, can diagnose the true causes of disorientation in space.

Causes

The following reasons for the occurrence of the phenomenon of confused consciousness are identified:

traumatic (consequences of penetrating traumatic brain injury);
in case of brain injury (organ tissues are highly sensitive);
the occurrence of an aneurysm (an enlarged blood vessel affects neighboring tissues);
mercury poisoning;
increased dose of alcohol in the blood;
drug intoxication;
effects of neurotropic gas on the respiratory system;
entry of organophosphorus compounds into the digestive system;
poisoning with neurotoxic substances – puffer fish, mushrooms, carambola;
hyperthermia resulting from infectious diseases;
pain shock during a fracture, dislocation, significant blood loss;
severe diseases - tuberculosis, encephalitis, diabetes mellitus, all types of hepatitis, acquired human immunodeficiency syndrome at the final stage of development;
progression of tumor growth at the last cancer stage (intoxication occurs during the process);
ischemic disease, all types of strokes, occurring both unnoticed and obvious;
myocardial infarction, with pronounced pain and impaired blood flow;
vegetative-vascular dystonia – vasodilation occurs in areas of the body’s autonomic system;
age-related diseases: senile dementia, Alzheimer's disease, marasmus of all types;
bright emotional outburst;
hypothermia;
a period without sleep for a long time;
oxygen starvation;
1st and 2nd degree stunning.

Loss of the ability to navigate the surrounding space can be caused by temporary pathological factors, such as intoxication or a drop in blood sugar, as well as neurological diseases, mental disorders that occur with psychotic episodes. The duration of disorientation, the ability to ask for help, and the use of compensatory functions (for example, memory) depend on the cause. Spatial disorientation is provoked by the following conditions:

Focal lesions of the central nervous system. Local damage to brain structures is one of the most common causes of spatial orientation disorders. The symptom is found in traumatic brain injuries, brain tumors, and strokes.
Neurodegenerative diseases. Violation of topographic orientation is observed in old, elderly people with Alzheimer's disease, Pick's disease, and other neurodegenerative pathologies. The inability to recognize the area and navigate a route occurs with the development of dementia, in a psychotic state.
Psychotic disorders. Patients with mental illness in a state of psychosis lose the ability to correctly assess themselves and the environment. They find themselves disoriented in space, time, and their own personality.
Use of drugs, alcohol. The state of alcohol or drug intoxication is often accompanied by a loss of the ability to determine one’s own location. The ability to act purposefully decreases, and planning a route becomes impossible.
Action of drugs. Disorientation may be a consequence of taking certain medications. As a side effect, it occurs when using antihistamines, muscle relaxants, tranquilizers, psychostimulants, some painkillers, and anti-inflammatory drugs.

Confusion: general characteristics

The disease is characterized by a person’s darkened consciousness, in which speech impairment, drowsiness and hallucinations are noted. The pathology is temporary or permanent, depending on the reasons for which it appeared. Confusion may develop against the background of psychological disorders, neurological diseases, or cerebral circulatory disorders.

Clinicians identify the following etiological factors that can lead to the development of this human condition:

drug intoxication;
psychological diseases;
encephalitis;
traumatic brain injury;
severe concussion
vascular diseases of the brain;
neurological disorders;
damage to the central nervous system;
metabolic disorders;
post-traumatic psychosis;
epileptic seizures and twilight states;
Alzheimer's disease;
toxic poisoning;
severe intoxication of the body and high body temperature;
multiple sclerosis;
alcohol intoxication and withdrawal syndrome;
hidden internal bleeding;
myocardial infarction;
artificial state (post-resuscitation).

What are the symptoms of disorientation?

️The earliest symptoms of disorientation and confusion look like a deterioration in attention and ability to concentrate on something. As the disease develops, communication with the outside world is destroyed, gaps appear in memories, and logic is distorted. The person cannot understand what happened, ceases to recognize people and objects, and loses the ability to pronounce words.

️Because of this, he experiences stress, feels depressed, withdraws into himself and loses mobility. One skill or several at once may be affected. Sudden disorientation can be paroxysmal and go away over a period of time. Temporary disorientation is different from permanent disorientation. In the second case, signs such as delirium, dementia, hallucinations, limited mobility, and silence are visible.

️In the described condition, mental activity is disrupted, perception is distorted, and memories are lost. The perception of oneself as a person, one’s physical body, and other people changes. Memory of yourself and them becomes fragmentary or disappears completely.

Depending on the type of illness, different symptoms occur:

● Memory loss; ● Deterioration of attention; ● Sleep problems; ● Dizziness; ● Disconnected thinking; ● The appearance of visions, hallucinations; ● Apathy; ● Loss of concentration; ● Speech impairment.

️ Allopsychic disorientation means a lack of understanding of where a person is, the present place and time. The sufferer cannot name his location, is confused about calendar dates and time of day, and also does not know what year it is.

️ Sexual disorientation manifests itself as same-sex attraction, hatred of the opposite sex, and transgenderism. The reasons for such disorientation may be different, and this phenomenon is in the process of being studied. As an assumption, a hypothesis was put forward about a genetic predisposition, and there are also examples that sexual disorientation appears as a result of mental trauma and violence experienced.

️ Errative disorientation means speech impairment when pronouncing and writing words. People sometimes tend to be errative deliberately, creating slang expressions, but distorted speech can also be a symptom of a neurological and mental disorder.

️ Topographic disorientation means a lack of understanding of where a person is at the moment; he cannot name the locality, country, address and place of residence. It is this type of illness that most often occurs in elderly people who leave home in light clothing and wander the streets, not understanding where they are.

Disorientation in time and space, manifested due to brain damage due to trauma, concomitant illness or due to age. The patient cannot name the date, time, time of day, year, time of year and his location, as well as remember his own address, or go to the place where he lived for some time, but has long since left.

Loss of disorientation, or rather orientation, can occur suddenly and be temporary or develop gradually, conquering a person’s perception and depriving him of his usual guidelines in life. In this case, they say that complete disorientation has occurred and the patient disappears as a person. He falls into a confused state, becomes sedentary and withdrawn, does not speak, and performs a minimum number of actions, because he no longer understands what and when to do. Needs constant supervision and care.

Disorientation

Disorientation is a symptom of a certain mental disorder or pathological process in the central nervous system. In some cases, the phenomenon may be short-lived, as a consequence of traumatic brain injury. The violation is manifested in the inability of a person to identify himself as a person, to determine his social position, the time in which he is located. Quite often, this symptom is diagnosed with organic brain lesions. Social or spatial disorientation due to excessive alcohol consumption or drug intoxication is no exception. It should also be noted that social disorientation in children of primary preschool and school age is a completely normal physiological process.

Clinicians identify the following predisposing factors for the development of this symptom:

psychological disorders that led to serious disorders of consciousness;
frequent stress, severe nervous tension;
alcohol intoxication or drug intoxication;
side effects of some medications, especially with regard to psychotropic substances (tranquilizers, antidepressants, sedatives);
the effects of radiation on the body;
consequences of anesthesia;
long-term depression.

Separately, we should highlight pathological processes that in the clinical picture have such a symptom as disorientation:

Short-term disorientation in time can be observed with a strong blow or severe moral shock. In such cases, quite often, this symptom is supplemented by confusion and fainting.

A one-time manifestation of such a symptom, which is short-term in nature, should not always be regarded as a sign of a certain pathological process. However, consultation with a neurologist is advisable.

What is a confused state?

In this process, the ability to think at an average speed disappears, the clarity and consistency of thoughts is significantly destroyed.

What is a confused state?
Causes
Symptoms
What is disorientation?
Current of development
Medical classification
Symptoms of the disease
Benefits of diagnostics

Signs of the disorder are problems with orientation in space and deterioration of attention. Logical thinking disappears and memory is degraded. The highest signs of the psyche change one by one. For example, only speech recognition may be affected. Memory problems are noted, spatial orientation is impaired. There are two types of confused consciousness, depending on the cause of its occurrence - fast and slow.

Manifestations can be one-time or permanent. Dementia and delirium are signs of the latter condition. The integrative function of thinking at the moment of confusion is absent. Along with the expected change, the patient is often silent, moves little, and is depressed outwardly. Illusions and hallucinations accompany the disease. The first arise because the body incorrectly perceives the stimulus, while hallucinations manifest themselves independently. Each individual suffers from the disease differently - the determining factor is the root cause of the development of the disorder. Slowness of thinking and inconsistency of logical series are emphasized during the first minutes of conversation. Even non-professionals can notice the initial symptoms.

Psychotherapists divide delirium into several classifications: hallucinatory (the ability to see non-existent information); manic (obsession with aggression); catatonic (inability to fully move); confabulatory (twisting of an obvious fact).

Loss of spatial orientation in flight

Topic: Loss of spatial orientation in flight

03/04/2011 aviapils writes:
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SOLVING THE PROBLEM OF LOSS OF SPATIAL ORIENTATION and control of an aircraft in flight. Functions of the Federal Air Transport Agency. The Federal Air Transport Agency (Rosaviation) is a federal executive body that carries out the functions of providing public services and managing state property in the field of air transport (civil aviation), use of the airspace of the Russian Federation, air navigation services for users of the airspace of the Russian Federation and aerospace search and rescue, functions for the provision of state services in the field of transport security in this area, as well as state registration of rights to aircraft and transactions with them. Position Disasters due to loss of spatial orientation by pilots in flight continue. Almost every year there are 2 - 3 disasters for this reason. March 22, 1994 A-310 near Mezhdurechensk. December 6, 1995 near Khabarovsk Tu-154B. March 11, 2006 Mi-8T a\p Varandey. February 22, 2006 Mi-8T near Krasnoufimsk. IAC conclusion: “...the cause of the disaster was the erroneous actions of the helicopter commander, which manifested itself in premature and unreasonably vigorous braking of the helicopter with a decrease in the overall pitch of the main rotor, which led to the helicopter entering the 'vortex ring' mode. Subsequent uncoordinated and disproportionate actions by the helicopter commander in low altitude conditions led to a collision with the ground." On August 23, 2000, during a go-around at night, it fell in the Arabian Gulf near the airport. Muharak, Bahrain aircraft A-320. Near Sochi, six years later, the disaster was repeated down to the last detail. Conclusions from the investigation into the disaster in Bahrain: pp. 3. “While performing a missed approach after circling, the flight crew appears to have experienced spatial disorientation (lost spatial orientation). pp. 4s. “The ship’s commander did not fully perceive the instrument information that was generated during the final stage of the flight, and he experienced information overload.” May 3, 2006 A-320 near Sochi. IAC conclusion: “...the cause of the crash of the A-320 aircraft (near Sochi) was the inadequate actions of its crew commander, while at the same time the co-pilot failed to pay attention to the landing parameters.” “In difficult weather conditions, the human factor played a role,” said Russian Transport Minister Igor Levitin. May 4, 2007 Boeing 737 in Cameroon Kenya Airways: “Spatial disorientation.” On the night of May 4, 2007, B737-800, Registration 5Y-KYA, flight KQA 507 from Abidjan International Airport (Côte d'Ivoire), bound for Jomo Kenyatta Airport, Nairobi (Kenya), made a scheduled stop at Douala International Airport. It's a stormy time. Soon after take-off at an altitude of about 1000 m, the plane begins to roll to the right, at first “slightly”, then the roll increases more and more. The plane goes into a deep spiral, from which the pilots cannot get out. 09/13/2008 B-737 crash in Perm. IAC conclusion: “The immediate cause of the accident was the loss of spatial orientation by the crew, primarily the PIC, who was actively piloting the aircraft during the final stage of the flight, which led to the aircraft flipping over the left wing, entering into an intensive descent and colliding with the ground. Loss of spatial orientation occurred while flying at night, in the clouds, with the autopilot and autothrottle disabled. December 19, 2009 Mi-171 near Vorkuta. IAC conclusion: “The immediate cause of the flight was the loss of spatial orientation by the crew after the descent due to distraction from monitoring the flight mode.” February 12, 2009 in Buffalo Bombardier Dach Q400 on approach. The US National Transportation Safety Board (NTSB) released its final report on the plane crash near Buffalo on February 12, 2009. According to this document, the main reason for the crash of the airliner was the actions of the crew commander, as a result of which the plane lost speed and went into a stall, after which it could not be leveled. In the coming months, the NTSB will take a deeper look at these issues - how to improve overall code, and pilot and controller excellence. These issues are larger than this accident, with far-reaching consequences for the aviation industry. One thing about this accident is that history is repeating itself. We must take quick and effective action on these recommendations. If the aviation community does not take them to heart, then we are destined to return to them again. This must not result in the loss of another 50 lives, so action must be taken urgently and we will do so. August 2, 2010 An-24RV, Igarka airport. IAC conclusion: The cause of the accident of the AN-24RV RA-46524 aircraft during the landing approach in conditions worse than the meteorological minimums of the airfield, the aircraft and the PIC for the landing approach using the OSP system was the failure of the crew to make a timely decision on a go-around and the aircraft descending below established minimum safe altitude (100m) in the absence of reliable visual contact with approach lights and runway lights, which led to the aircraft colliding with trees and the ground in controlled flight. When landing at Igarka airport, at dusk, using the OSP system with MK pos-117gr. The aircraft collided with trees at a distance of 477m from the runway entrance and 234m to the right of the runway axis. The ICAO classification is CFIT - Controlled Flight Terrain (CFIT), a term used to describe accidents involving an aircraft colliding with terrain or water where the crew could control the aircraft's direction and speed, is still responsible for more number of accidents than any other incidents related to air transport. But is it correct to classify the disasters that occurred this way? Loss of spatial orientation is a purely psychophysiological situation inherent to the pilot as an individual, and occurs due to the lack of appropriate, vital instrumentation in aircraft cockpits. For example, if oxygen equipment fails during a flight and a disaster occurs, then in this case it will be classified as: “Failure of aircraft oxygen equipment.” Spatial orientation is the same vital function of the human body as breathing. To solve the problem of loss of spatial orientation with further loss of control of the aircraft, the above disasters must be classified as: “Lack of vital equipment in the aircraft cabin.” Thus, the actions of pilots in Bahrain, near Sochi, Perm, Buffalo must be considered as actions in a stressful situation, with insufficient information, in a shortage of time, due to absence in the cockpit. necessary indication for maintaining correct spatial orientation. Psychophysiological aspects of the origin and process of loss of spatial orientation with further loss of aircraft control are discussed in the journal “Problems of Flight Safety” No. 12, 2006 in the article “Loss of spatial orientation and control of an aircraft in flight.” The following conclusions were made: 1. In the cockpits of modern aircraft, for orientation in space and safe control, an indication is used that is not suitable for solving these problems. 2.In the cockpits of modern aircraft it is necessary to install two new indicators: a). Flight indicator for solving problems of safe aircraft control. b). Indicator for spatial orientation of the pilot in any flight weather conditions. The essence of the problem and its solution: Currently, in the cockpits of aircraft, both military and civilian, two types of main aviation instruments are used - attitude indicators - indicators of the angles of roll, pitch, and sideslip of an aircraft in flight. Type 1 – the so-called direct (“American”) indication of roll and pitch angles (see Fig. 1). Used on all types of Western-made aircraft and helicopters. On the display screen, the pilot observes a stationary, stylized silhouette of his aircraft, visible to the pilot from behind during the flight, relative to which a movable line of the conventional horizon rotates in roll and moves in pitch, repeating the position of the true horizon line visible from the cockpit. Fig. 1. Type 2 – the so-called mixed (Soviet) indication of roll and pitch angles Fig. 1. Currently used only on Russian military aircraft and helicopters. On the indicator screen, the pilot observes a stylized silhouette of his aircraft, mobile in roll and stationary in pitch, relative to which the line of the conventional horizon moves in pitch, motionless in roll. Fig.2 Airworthiness standards for transport category aircraft AP - 25 Section F - Equipment GENERAL PROVISIONS 25.1301 Purpose and installation. Each piece of installed equipment must: (a) Be of a type and design suitable for its intended purpose. 25.1303 Flight and navigation instruments. (b) The following flight navigation instruments must be installed on each pilot's instrument panels: (5) Roll and pitch indicator (gyro-stabilized). 25.1309 Equipment, systems and installations. (a) Equipment, systems and installations whose intended purpose complies with the requirements of these Standards must be designed to ensure that they perform their intended functions reliably under all expected operating conditions. Help: Aerodynamics (of all aircraft) gives a clear, unambiguous definition of the aircraft's roll angles: right roll is positive, left roll is negative. In the American “direct” roll indication, when creating, for example, a left roll of an aircraft (see Fig. 1), the pilot observes how the instrument’s roll indicator (triangular index at the top) moves along the roll scale to the right, indicating a right roll. When the aircraft is left - negative roll, the indicator shows right - positive roll, and vice versa. Therefore, its true name for roll: “Reverse roll indicator”. Help: Aerodynamics: aircraft pitch - pitch (Q) is the angle between the associated longitudinal axis of the aircraft (X axis) and the horizontal plane of the earth. In the American “direct” pitch indication (see Fig. 1), when the pilot creates, for example: a dive - negative pitch, (the nose of the piloted aircraft - down) the longitudinal X axis of the indicator - the silhouette of the aircraft remains stationary, and the horizon line moves parallel upward . Moving two parallel lines relative to each other does not create angles. This movement indicates a change in the aircraft's altitude position. The true name of the “direct” pitch indicator is the “Aircraft Altitude Change Indicator.” Thus, the true name of the American “direct” roll and pitch indicator is: “Reverse Roll Angle and Altitude Change Indicator.” Does not comply with §25.1301(a); 25.1303(b)(5); 25.1309(a). When creating pitch angles of more than 35 degrees, the horizon line goes up or down beyond the edge of the device. The pilot observes a blue or brown background on the pitch scale, which does not comply with paragraph 25.1309 (a) Equipment, systems and installations, the purpose of which meets the requirements of these Standards, must be designed in such a way as to ensure the reliable performance of their intended functions under all expected operating conditions. Direct (American) indication is illegitimate and should not be installed in aircraft cockpits, since it cannot serve the pilot as: “Indicator of roll and pitch angles”, without ensuring the correct spatial orientation of the pilot and safe control of the aircraft in difficult flight weather conditions. It is necessary either to change the requirements of the “Aviation Rules AP-25”, as they relate to instruments or indicators of roll and pitch, or to recognize the existing “direct” indicators as counterfeit. Disasters due to the following reason: “Loss of spatial orientation by the pilot in flight” will continue until the American “direct” indicator of attitude indicators in airplane cockpits is replaced. According to Appendix No. 9 of “Aviation Rules - 21” (clause 8.2.2 Technical requirements for means of determining and indicating roll and pitch). “Indication of the roll and pitch of the AGN should be carried out as seen from the aircraft to the ground (the line of the artificial horizon - artificial horizon is parallel to the true horizon) and provide the crew with an idea of the aircraft’s position relative to the true horizon, in the ranges of ± 360 degrees in roll, and ± 75 degrees in pitch. These technical requirements for instruments - attitude indicators are absolutely incorrect and require changes, both in terminology and concepts. In the definition: “Indication of the roll and pitch of the AGN should be carried out in the form “from the aircraft to the ground,” incompatible concepts are correlated. Roll and pitch are the parameters of the aircraft’s position in space, i.e. the position of the coordinate system associated with the aircraft (X1,Y1,Z1) in relation to the earthly one (X,Y,Z). To display these parameters “from the plane to the ground” or “from the ground to the plane” is to mislead the pilot. The pilot knows that his plane is moving in space, and the “view from the plane to the ground” invites him to see his plane motionless on the indicator screen and observe the moving environment. This indication is illogical in its essence. In addition, both types of indicators contain both a “view from the ground to an airplane” - a stylized silhouette of an airplane, and a “view from an airplane to the ground” - the movement of a line of a conventional, rather than artificial, horizon. Developers of displays of types 1 and 2 are trying to combine in one indicator the solution of two main flight tasks: to provide correct spatial orientation, for which an artificial horizon line was installed in the device, and to ensure safe control of the aircraft, for which purpose the silhouette of the aircraft was made motionless in the device. As can be seen from the above, the solution to both problems in one indicator is not achieved, which leads to a loss of spatial orientation and control of the aircraft in flight. Conclusion: It is necessary to install two information systems in the cockpits of modern aircraft: 1). Indication in any flight weather conditions of the line of the artificial horizon according to its position, movement and parameters of the corresponding line of the true (natural) horizon visible to the pilot from the cockpit. 2). Indication of the position and movement in space of one's aircraft, made on an indicator in the form of a three-dimensional model moving in roll and pitch, relative to a stationary line of the conventional horizon. In the technical requirements, it is necessary to clearly separate the requirements for two different devices: Clauses. 8.2.2. “Flight indicator - indication of the angles of roll, pitch, slide and other parameters of the position and movement of the aircraft in space must be carried out correctly, and provide the crew with an idea of the position of the aircraft in space in the true (fixed) coordinate system in the range: + / - 360 degrees. by roll; + / - 90 deg. in pitch." pp. 8.2.3. “The spatial orientation indicator - indication of the line of the artificial horizon, the earth, parallels and meridians, must be carried out in the entire range visible from the aircraft cockpit, and provide the aircraft crew with an idea of the position of the true horizon and earth in any flight weather conditions.” Authors: Plentsov Alexander Panteleevich – 1st class military pilot. Evgeniy Aleksandrovich Porosenkov – research engineer. Mikhail Nikolaevich Glushchenko – research engineer.

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Symptoms of the disease

Most often, there is a disturbance in orientation in space (the patient is not aware of where he is) and in time (he forgets dates and days). Both options can be combined.

True confusion is usually the result of illness, injury, or a side effect of medications.

Children and adolescents may experience social disorientation due to major life changes. Young children have difficulty distinguishing between gender and occupation, and they are disturbed by the company of strangers. This is considered a normal physiological phenomenon that goes away during adolescence.

In other conditions, disturbances of consciousness require specialist consultation, since they may be a sign of serious diseases (dementia, mental retardation).

Early signs of a pathological condition are deterioration of attention and memory. A person’s perception of the world changes, disturbances are observed at the emotional level and problems with speech begin.

Sometimes illusions are added - incorrect perception of current events or hallucinations - visual and auditory sensations that do not actually exist. The patient is gloomy, silent, depressed, and inactive.

For a primary diagnosis, it is necessary to detect the active progress of processes:

shallow memory lapses (information is lost within a few minutes);
the patient cannot recognize his loved ones, as well as basic passport data;
there is no memory of the person’s information field;
disorientation;
unconditional changes in mood (an aggressive mood can be used even on close people);
there is no logical chain in the pronunciation of phrases (pronunciation speed is below average);
lack of control over the bladder and sphincter (constant urination and defecation);
Normal sleep is completely disrupted.

Due to internal bleeding, additional aspects appear: increased volume of sweat; bleeding of the skin; black defecation products; high blood pressure; worsening breathing; tachycardia.

Psychological disorder, in turn, contains the presence of inadequacy in behavior, aggressive attacks, lack of normal sleep, terrorizing the immediate environment, the emergence of helplessness and the collapse of a clearly established internal model of behavior.

Changes that help establish the diagnosis are pronounced dizziness, variable mood, disturbed sleep, problems with remembering facts, inability to identify a person, internal psychological anxiety without outside provocation.

Spatial symptoms stand out: a sharp change in mood - an apathetic state changes to an aggressive one.

Help in this situation can only be found in a specialized institution that works with psychologically unbalanced people.

A separate category is social disorientation, which cannot be classified as a mental disorder. Its specific features: unclearly pronounced age, long-term adaptation to society, anxiety in an unusual situation.

The diagnostic complex involves an initial consultation with a psychotherapist and a neurologist. The doctor carries out manipulations with the patient, a full physical examination, with questions that help establish the correct diagnosis. From the point of view of physical manipulations, there is blood sampling for biochemistry and general clinical analysis.

Confusion and temporary loss of orientation can be symptoms of very serious illnesses. If disorientation is accompanied by weakness in the limbs and slurred speech, we can talk about a transient ischemic attack or stroke.

If disorientation is accompanied by a high temperature, there is likely a severe infection in the body.

In any of the above cases, you should immediately consult a doctor.