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Occupational delirium (delirium of employment, delirium of occupation) is delirium with a predominance of monotonous motor excitation in the form of habitual actions performed in everyday life. eating, drinking, cleaning, etc., or actions directly related to the profession of the sick person - dispensing goods, sewing, working on a cash register, etc. Motor agitation in occupational delirium occurs, as a rule, in a confined space. It is accompanied either by the pronunciation of individual words or is “silent”. Hallucinations and delusions are either absent or rudimentary. Speech contact is often impossible. Sometimes you can get a one-word answer. Its content reflects pathological experiences.
Delirium delirium (delirium with muttering, quiet delirium) is delirium with uncoordinated motor excitation, which is devoid of integral actions and monotonous in its manifestations, occurring within the bed. Patients take something off, shake it off, feel it, grab it. These actions are often defined by the word "robbing". Speech agitation is a quiet and indistinct pronunciation of individual sounds, syllables, and interjections. It is impossible to communicate with patients; they are completely detached from their surroundings. Delirium usually gives way to professional delirium. Occupational and especially excruciating delirium during the daytime can be replaced by symptoms of stunning. The deepening of stunning in these cases indicates a worsening of the underlying disease.
Depending on the etiological factor (with the greatest frequency during intoxication), delirium may be accompanied by autonomic and neurological disorders. Autonomic disorders include tachycardia, tachypnea, sweating, fluctuations in blood pressure with a tendency to increase, and neurological symptoms include muscle hypotension, hyperreflexia, tremor, ataxia, convergence weakness, nystagmoid, and Marinescu's symptom. In severe delirium, primarily in delirium delirium, blood pressure drops, collaptoid states may develop, severe hyperthermia of central origin is often observed, and symptoms of dehydration are observed. Neurological symptoms include nuchal rigidity, Kernig's sign, symptoms of oral automatism, ocular symptoms (nystagmus, ptosis, strobism, fixed gaze), athetoid and choreoform hyperkinesis.
The duration of delirium usually ranges from three to seven days. The disappearance of disorders often occurs critically, after prolonged sleep. Deviations from the average duration are possible both in the direction of shortening and in the direction of significantly prolonging the existence of symptoms defining delirium. In somatically weakened patients, primarily in the elderly, extensive and severe delirious patterns can be observed for a number of weeks. Patients who have had full-blown deliriumastically remember the content of experiences. Usually these memories are fragmentary and relate to psychopathological symptoms - hallucinations, affect, delusions. In patients with occupational and excruciating delirium, complete amnesia is observed.
