Obnubilado: Symptoms, Differences, Causes, Diagnosis and Treatment

A series of medical disorders can cause a decrease in alertness, sometimes even with the risk of injury or death.

Obnubilation is a condition similar to lethargy.

The term conscience describes the ability to be alert and respond to any change in our environment.

Under normal circumstances, human consciousness can be of two types: wakefulness, which describes the fully alert state in which we function when we are not asleep, and sleep, in which the mind and body are temporarily inactive, but can awaken.

Consciousness is governed by two parts of our brain: the brain and the brainstem.

The brain interacts with the brainstem and keeps us alert, but it can also change this level of alertness by receiving feedback from our sensory organs, such as eyes, skin and ears.

When there is an undesirable change in blood flow to the brain, or the brain suffers an injury, abnormal states of consciousness can be experienced.

Unlike the two states of normal consciousness, there are a number of abnormal states. One of these altered states of consciousness is obtundation.

What does obfuscation mean?

The obnubilación is a state in which the level of conscience of a person is reduced moderately due to a medical condition or trauma. Such an individual is less aware of his environment and does not respond, but can be awakened by verbal or physical stimuli.

The term obtundation is influenced by the Latin word obtundere, which means boring or blunt, since such patients exhibit awkwardness.


  • Disorientation.
  • Lack of response
  • Without noticing the surroundings.
  • Response to strong verbal and physical stimuli.
  • The answer takes a long time.
  • Drowsiness and increased sleep periods.
  • Response to painful stimuli by vocalization, grimacing and attempts to eliminate the stimulus.
  • Changing your position while you sleep.
  • Try to eliminate needles and intravenous catheters.

Difference between obtundation, lethargy and stupor

These terms are the different stages of an altered level of consciousness (ALC). This is a condition in which an individual is less aware of the external environment compared to a completely alert individual.

The different stages of ALC, from mild to severe, are lethargy, obtundation, stupor and coma.

Therefore, lethargy is a slight decrease in consciousness, and a lethargic person can be awakened by a simple verbal stimulus such as screaming.

Obnubilation implies a greater, but still moderate, drop in levels of consciousness. Such people may be temporarily awakened by repeated verbal or physical stimuli, such as vigorous shaking, but may not respond again.

Stupor is a deep state of lack of response, and such individuals may even need a painful stimulus (such as pinching) to awaken them.

On the other hand, a patient in a coma does not respond completely and does not react even to something painful.

What causes the obfuscation?

Some drugs, and even minor physical ailments such as dehydration, can make older people slow, but altered consciousness has dozens of possible causes for people of any age.

A head injury, stroke, tumor, drugs, alcohol, seizures, heart failure, carbon monoxide, and even infections or altered levels of blood sugar can make a patient feel dizzy and even progress to stupor.

  • Diabetes and its complications.
  • Liver / kidney diseases.
  • African trypanosomiasis (sleeping sickness).
  • Over bubonica.
  • Cranial injury
  • Sleep deprivation for long periods.
Metabolic disturbances
  • Very high / low sodium levels.
  • Very high / low blood pH.
  • Low levels of phosphate
  • Increase in the level of carbon dioxide in the blood.
  • Low level of oxygen in the blood.
Circulation of blood / heart problems
  • Severe heart failure
  • Very low / high blood pressure.
  • Inflammation of blood vessels.
Problems in the nervous system
  • Brain cancer
  • Infections of the brain, such as encephalitis .
  • Encephalopathy (diseases that alter the structure of the brain).
  • Central pontine myelinolysis (damage to nerve cells in the brainstem.
Substance abuse
  • Alcohol intoxication or poisoning.
  • Overdose of opiates, narcotics, anticonvulsant drugs and sedatives.
  • Toxins such as hydrocarbons or heavy metals.

The human brain can adjust its alertness level as necessary through the information obtained from the sensory organs.

But when external agencies come into contact with the brainstem, altered levels of consciousness may be unavoidable.

Disorientation, or a general reduction in alertness, can often lead to stupor if medical care is not administered quickly.

Diagnosis and treatment

Because doctors may not be able to communicate with a patient whose consciousness is impaired, family and friends must communicate their knowledge of any drug or alcohol use by the patient.

Someone who has taken an overdose of drugs, for example, may be obtuse but able to communicate. It is said that a patient who can only wake up intermittently is in a state of stupor.

First a physical examination is performed, which includes a reading of the body temperature, to determine the possible causes.

The stimuli will then be applied; If the patient reacts, the conscience is not severely affected. Abnormal breathing patterns or reactions to reflex stimulation can also help determine alert levels.