Symptom Finder - Nightmares
NIGHTMARES
The mnemonic PINT will help to recall the causes of nightmares.
P—Psychiatric causes include anxiety, neurosis, and the various psychoses.
I—Inflammation prompts the recall of nightmares associated with systemic infections, and intoxication brings to mind the nightmares due to alcohol and drugs such as the benzodiazepines.
N—Neurologic disorders prompt the recall of epilepsy.
T—Trauma facilitates the recall of head injury as a common cause of nightmares.
Approach to the Diagnosis
If an infectious disease is suspected, a CBC, sedimentation rate, and chemistry panel should be done. Alcohol- or drug-induced nightmares may be diagnosed by the history and a drug screen. The history should also be useful in cases of head injury, especially when questioning the family or closely associated persons. If epilepsy is suspected, a wake-and-sleep electroencephalogram should be ordered; a trial of anticonvulsants may be necessary to rule out epilepsy. It may be useful to order a psychiatric consult early in the evaluation.
The mnemonic PINT will help to recall the causes of nightmares.
P—Psychiatric causes include anxiety, neurosis, and the various psychoses.
I—Inflammation prompts the recall of nightmares associated with systemic infections, and intoxication brings to mind the nightmares due to alcohol and drugs such as the benzodiazepines.
N—Neurologic disorders prompt the recall of epilepsy.
T—Trauma facilitates the recall of head injury as a common cause of nightmares.
Approach to the Diagnosis
If an infectious disease is suspected, a CBC, sedimentation rate, and chemistry panel should be done. Alcohol- or drug-induced nightmares may be diagnosed by the history and a drug screen. The history should also be useful in cases of head injury, especially when questioning the family or closely associated persons. If epilepsy is suspected, a wake-and-sleep electroencephalogram should be ordered; a trial of anticonvulsants may be necessary to rule out epilepsy. It may be useful to order a psychiatric consult early in the evaluation.
