NIGHTMARES
Ask the Following Questions:
- Are they acute or chronic? The presence of acute nightmares should make one think of the possibility of infectious disease, acute situational maladjustment, or a head injury. Remember, there may be amnesia from the head injury. Chronic nightmares may be associated with drug or alcohol use, epilepsy, and neuroses or psychoses.
- Is there a history of trauma? Nightmares following trauma may be due to the acute anxiety associated with the trauma or actually to a head injury.
- Is there a history of drug or alcohol use? Acute alcoholic intoxication can create hallucinations and nightmares. Chronic alcoholism can lead to delirium tremens. Benzodiazepines and numerous other drugs may cause nightmares.
- Is there a history of tongue biting or incontinence? These findings suggest grand mal epilepsy. Nightmares may result from complex partial seizures without tongue biting or incontinence.
DIAGNOSTIC WORKUP
A CBC, sedimentation rate, and chemistry panel will help rule out infectious diseases. A urine drug screen will help rule out the possibility of drug-induced nightmares. A wake-and-sleep EEG will help diagnose epilepsy. If epilepsy is strongly suspected, a therapeutic trial of anticonvulsants may be necessary. If the workup is negative, referral to a psychiatrist or psychologist is in order.
Book Source Details
- Book Title: Algorithmic Diagnosis of Symptoms and Signs
- Author(s): R. Douglas Collins
- Year of Publication: 2003
- Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.
Other Book Chapters Related to Nightmares
Read excerpts from these other book chapters related to Nightmares:
Medical Books Excerpts
- NIGHTMARES
- "Algorithmic Diagnosis of Symptoms and Signs" (2003)
- [ read ]
Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.
More About Causes of Nightmares
» Next page: Hallucinations (In a Page: Signs and Symptoms)
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