From Big Medical Encyclopedia

NIGHTMARES (pavor nocturnus, the singular) — the conditions of the expressed fear and motive concern which are observed sometimes at children during a night dream. N. is frequent pages are followed noctambulation (see) and disturbances of perception. According to Curt (E. Kurth) et al. (1965), N. pages at children occur in 4,4%, and among the children sick with epilepsy, in 8,2% of cases; at boys are observed twice more often than at girls.

More often than N. pages are connected with psikhogennonevrotichesky, including hysterical, frustration, more rare are manifestation of neurosis-like frustration at somatopathies, organic lesions of a brain, schizophrenia. The repeating N. of page can be one of symptoms of temporal epilepsy (so-called paroxysmal N. page).

N of page connect with disturbances of a phase of slow dream (see). Clinical picture various. As a rule, N. of page arise against the background of the broken consciousness: the child during a night dream becomes uneasy, feels strong fear, shouts, cries, asks to banish someone that demonstrates existence at it of hallucinations and other disorders of perception. Often the child calls mother though he usually does not recognize her and does not answer her questions; quite often it jumps, sits down in beds. Vegetative frustration are at the same time noted: general perspiration, tachycardia, mydriasis. It is not possible to wake and calm the child. Such states last up to 15 — 20 min., are replaced by a dream, can repeat. The child does not remember page the N. N. is frequent pages arise during the awakenings against the background of undisturbed consciousness. At the same time they or are connected with the psychoinjuring day events (a fright, punishment, a quarrel, etc.), to-rye can be reproduced in dreams, or are combined with crazy or hallucinatory disturbances.

N of page at temporal epilepsy are stereotypic, arise at the same time a dream against the background of deep stupefaction, are followed by the various automated movements, an involuntary urination.

Diagnosis also the wedge, pictures is put on the basis of data of the anamnesis. The differential diagnosis is carried out with so-called nightmares (the frightening dreams which are followed by awakening), at to-rykh disturbances of consciousness, disorder of perception are not noted, the subsequent amnesia is not observed.

Treatment it is carried out taking into account the reason which caused N. of page. At N. of page of a psychogenic and neurotic etiology the psychotherapy against the background of reception of tranquilizers (especially groups of diazepam) for the night is effective. These drugs are shown also at N. to page of a neurosis-like origin. At paroxysmal N. pages appoint carbamazepine (Tegretolum), and also other means applied at temporal epilepsy (see. Epilepsy ).

Forecast at N. of page of a psikhogennonevrotichesky etiology, and also neurosis-like origin, as a rule, favorable; at N.'s schizophrenia of page have passing character. Paroxysmal N. of page tend to transformation in more difficult attacks of temporal epilepsy.

Prevention it is directed to the prevention of the basic diseases causing N. of page and also to normalization of a sleep pattern of the child (observance of the same time of withdrawal to a dream, an exception of exciting impressions in the evening, carrying out the last feeding not less than in 2 hours prior to a dream).

Bibliography: Garbuzov V. I., Zakharov A. I. and Isaev D. N. Neurosises at children and their treatment, page 111, JI., 1977; About l and A. Ts N. A pathological dream at children, page 139, JI., 1979; Kovalyov V. V. Psychiatry of children's age, page 49, M., 1979; Go lini t z G. Neuropsychiatrie des Kindes-und Jugendal-ters, S. 320, Jena, 1970; K a n n e r L. Child psychiatry, p. 499, Springfield, 1966; Kurth E., G o h 1 e r I. u. K n an a-p e H. H. Untersuchungen iiber den Pavor nocturnus bei Kindern, Psychiat. Neurol. med. Psychol. (Lpz.), Bd 17, S. 1, 1965.

B. B. Kovalyov.