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Stupor is a state of diminished awareness and responsiveness in which consciousness is clouded. The most familiar example is the condition that occurs when a person indulges in too much alcohol. Sometimes the term is used figuratively to describe a person who is simply oblivious to his or her surroundings, as in the statement: "He goes around in a stupor." Medically, however, a stuporous state often indicates a severe disorder.

Causes of stupor

Alcoholism
Alcohol alters brain chemistry in several ways. Taken in small amounts, it has a tranquilizing effect, producing drowsiness and a dulling of the senses. In larger amounts, it impairs memory, concentration, judgment, and coordination. Speech becomes slurred and physical responses are slowed. If drinking continues, the person becomes confused or stuporous and may even lose consciousness. These responses may be a direct effect of the alcohol on the brain. They may also be due to a rapid drop in blood sugar (hypoglycemia), which can cause weakness, confusion, and altered consciousness.

Depression
The most severe form of manic depression sometimes produces a stuporous state in which the person is extremely unresponsive. The person sleeps a lot, and even when awake is unable to get up. This type of depression is referred to as benign stupor or stuporous melancholia.

Diabetes
Either too much or too little insulin can result in serious complications. Without insulin, the body is unable to utilize blood sugar (glucose), its major fuel, and instead breaks down stored body fat. Excessive fat metabolism leads to a buildup of toxic substances called ketone bodies, which can cause dehydration, a drop in blood pressure, stupor, and (if untreated) shock and death. Conversely, excessive insulin can cause a severe drop in blood glucose, which can also lead to stupor and coma.

Drug overdose
An overdose of many illicit drugs as well as prescription medications can cause stupor. Heroin, for example, can produce a stuporous state. Sleeping pills, tranquilizers,

antipsychotic drugs, and narcotic painkillers are among the medications that may have similar effects, especially when taken in large amounts or when consumed with alcohol or other drugs that suppress the central nervous system.

Encephalitis
This is an inflammation of the brain, usually due to a viral infection. Symptoms of mild encephalitis are similar to those of any viral illness. In more severe cases, however, brain function is altered, and symptoms include irritability, drowsiness, and stupor, perhaps developing into coma.

Epilepsy
Some types of epilepsy, such as petit mal seizures, can produce altered consciousness resembling stupor. Following a grand mal seizure, most epilepsy patients experience a stuporous state that resembles a coma.

Head injuries
Stupor or other symptoms of altered consciousness following a head injury should be investigated promptly to rule out a concussion, fractured skull, or cerebral bleeding. After a fall or head injury, a child should be carefully observed for a day or so for unusual drowsiness, which may indicate a brain injury that requires treatment.

Reye's syndrome
This is a serious childhood illness that follows a viral infection, usually the flu or chickenpox. Symptoms include severe and persistent vomiting, behavior changes, irritability, stupor, and possible coma.

Schizophrenia
Some types of schizophrenia are characterized by total withdrawal and unresponsiveness, a state referred to as catatonic stupor. This usually occurs in the more severe forms of schizophrenia, and may be accompanied by catalepsy, in which the person goes rigid or assumes a fixed, trance-like posture.

Sleep disorders
Certain sleep disorders are characterized by stuporous states. During sleepwalking, for example, the person may appear awake but is actually in a stupor. A person with sleep apnea may be excessively drowsy or stuporous during the day.

Stroke
During a stroke, the blood supply to a portion of the brain is disrupted, either by a blocked artery or a cerebral hemorrhage. Symptoms vary according to the location and severity of stroke, and may include paralysis (usually on one side), visual disturbances, speech impairment, numbness, stupor, and loss of consciousness. In a mini-stroke, or transient ischemic attack (TIA), these symptoms are temporary, but are a warning of a possible impending stroke.