EpistemisDissociative fugue
Specialty: Psychiatry.
Why it occurs
- Extreme post-traumatic stress disorder
- Dissociative identity disorder
- Borderline personality disorder under intolerable stress
- Temporal lobe epilepsy (twilight states)
- Intoxication or withdrawal from alcohol/psychoactive substances
- Simulations for legal purposes or evasion of responsibilities
Initial workup
Immediate general physical examination to rule out trauma or dehydration; Wake and sleep EEG to rule out non-convulsive status epilepticus; Brain MRI; complete toxicological screening.
red flags
Patient located in another geographic region with alternative identity or identity amnesia, exposed to dehydration, hypothermia, crime or traffic accidents due to disorganized wandering.
Standard management
- Lorazepam — can facilitate the reduction of the dissociative barrier through conscious sedation
- Atypical antipsychotics such as Olanzapine — in case the escape occurs in a psychotic context or extreme psychomotor agitation
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Psychiatry
- Listed causes
- 6
- Treatment options
- 2