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Recovery of children after severe head injury. Psychoreactive superimpositions
Insights
Injured children may develop a "Sleeping Beauty syndrome," a psychoreactive stupor mimicking coma after intensive care. This can delay crucial early rehabilitation by misjudging recovery, highlighting the need to consider psychological factors post-head injury.
Area of Science:
- Pediatric Neurology
- Child Psychology
- Trauma Psychiatry
Background:
- Intensive care units (ICUs) present a psychologically impactful environment for children recovering from injury.
- Head injuries can alter a child's reactivity, potentially leading to abnormal psychiatric responses.
Observation:
- Children may exhibit a feigned-death response, resembling an organic coma vigile (apallic state).
- This psychoreactive stuporous state, termed "Sleeping Beauty syndrome," can be mistaken for a lack of recovery.
Findings:
- The syndrome can lead to misjudgment of a child's recovery status.
- Delayed recognition of this syndrome can impede timely and effective early rehabilitation efforts.
Implications:
- Understanding the interplay of physiogenic and psychogenic factors is crucial for managing psychiatric sequelae after pediatric head injury.
- Early identification and appropriate management of "Sleeping Beauty syndrome" are vital for optimizing recovery trajectories in injured children.
Abstract:
After the regaining of consciousness and awareness in the strange environment of an intensive care unit, an injured child is exposed to a situation of extreme psychological impact. This situation, in addition to a probably organically changed reactivity, is liable to provoke a particular, abnormal psychic response. The abnormal reaction can follow the pattern of a feigned-death response and thus mimic an organic coma vigile (apallic state). The resulting psychoreactive stuporous state ("Sleeping Beauty syndrome") may lead to a misjudgement of the recovery degree and may delay early rehabilitation. With the help of a representative case, the clinical manifestation, course, and treatment of this reactive juvenile syndrome are presented. The interaction of physiogenic and psychogenic factors responsible for some psychiatric sequelae during the early period after head injury is emphasized.