Journalistenservice

New study: Confusion syndromes often of neurological, not psychiatric nature
Neurologists also discuss sleepwalking phenomenon: High level of injuries might explain crimes

ENS 2010: 3,000 neurologists meet in Berlin

New study: Confusion syndromes often of neurological, not psychiatric nature

Neurologists also discuss sleepwalking phenomenon: High level of injuries might explain crimes

Acute confusion syndromes have in more than half of all cases a neurological origin, and not, as often assumed, a psychological one, experts say at the Annual Meeting of the European Neurological Society in Berlin. Some two to four per cent of adults in Europe sleepwalk. With increasing age, the risk of injuring oneself and others also rises, report researchers at the annual meeting of the European Neurological Society in Berlin. Imaging processes allow doctors to better understand the cause for sleepwalking.

Berlin, 21 June 2010- "In more than fifty per cent of cases, a brain disease causes a suddenly occurring case of confusion of the patient," says Prof Claudio Bassetti from the Zurich University Hospital and Neurocentro dell Svizzera Italiana, Lugano. Today made a presentation study on this topic at the Meeting of the European Neurological Society (ENS) in Berlin. "This means that when someone shows symptoms of acute confusion, we will have to consult neurologists and not psychiatrists in the future."

As a rule, the occurrence of acute confusion symptoms can be broken down into two groups: "The causes for acute confusion are manifold," says Professor Bassetti. "Within the nervous system, meningitis can, for instance, be the trigger, or an epileptic fit. Outside the nervous system, this is often a metabolic or toxic condition, such as liver or kidney insufficiency or drugs."

Confusion symptoms occur frequently in intensive care units and in patients after an operation. "Figures show that some twenty to fifty per cent of patients in intensive care wards show acute confusion symptoms, mostly two to three days after admission," the neurologist explains. The risk of acute confusion symptoms is also particularly high after heart operations. Thirty to fifty per cent of patients receiving a bypass operation or an operation on their open heart are affected by this.

But not only diseases, also prior pollution levels can trigger this condition. "As a rule, every patient must be treated differently, but there are some indicators for an increased risk: If the patient is older than 65, dement, depressive or dehydrated, the probability of suffering an attack increases hugely," says Prof Bassetti. "If the patient is younger, illicit drugs always have to be taken into account, because they can also trigger a condition of acute confusion."

For the future, Prof Bassetti recommends that patients affected be first examined by a neurologist and then by a psychiatrist. Because without adequate treatment of the cause, confusion syndromes can result in complications such as hallucinations or subsequent injuries. Some 35 to 40 per cent of hospital patients, in whom acute confusion syndromes occur, die after one year. Furthermore, the doctor calls for a better information of the family members of elderly patients: "Many medications which we use in every day life can trigger confusion syndromes in combination with other drugs," explains the neurologist.

One third of sleepwalkers injure themselves or others - indications for investigating crimes

Another topic on the agenda of the ENS Congress in Berlin is the often-underestimated matter of sleepwalking. "Two to four per cent of adults in Europe are sleepwalkers, far more than previously assumed," reports Prof Bassetti. "With increasing age, the risk of injuring oneself or others increases greatly." In the study presented by Prof Bassetti, it was shown that 30 per cent of the sleepwalkers examined injure themselves or others.

"This insight will also have an impact on investigating crimes," is Prof. Bassetti's conviction. Abnormal sexual behaviour can also occur in sleepwalkers. Those affected undress, have sex while asleep, masturbate or rape, in the worst case, their partner. "But not every sleepwalker is a violent criminal," the neurologist continuous reassuringly.

Dissociation between brain and body

Medically, scientists can now better understand what happens in the body of a sleepwalker. "With the use of imaging methods, we can now say with certainty that sleepwalking is caused by a dissociation between brain and body. Some regions in the brain are already active while others are not. The body is already awake, while the mind is still asleep," explains Prof Bassetti. Sleepwalking is one of the most puzzling phenomena in medicine to this day.

Alarm bells for neurological diseases

Experts can also provide new findings as regards the causes of the disease. "Today, we know that sleepwalking can also be the expression of a neurological disease such as Parkinson's or epilepsy," Prof Bassetti. Epileptics suffer from a special form of sleepwalking. It is also called "epileptic walking at night". If the doctors can detect a neurological disease as the origin of sleepwalking, the drugs to treat the disease help to get to grips with the sleepwalking. "It is nevertheless also advisable to take safety measures in order to avoid injuries," says the doctor.

ENS press office:

Dr. Birgit Kofler

B&K Bettschart&Kofler Medien- und Kommunikationsberatung

e-mail: kofler@bkkommunikation.com

mobile: +43-676-6368930, phone: +43-1-3194378