Stupor is a lack of response and a brief awakening that can only be induced by strong, repeated stimulation. When these functions are impaired, the normal state of wakefulness is impeded, and the symptoms can be brief or long-lasting, and can be mild or severe. Lethargy and coma are both extreme forms. In syncope, a brief period of unconsciousness may occur. When a convulsive seizure occurs, the confusion lasts longer; when a mild concussion occurs, the coma can last up to 1 hour. Complete coma lasting more than a few hours is usually caused by severe intracranial or metabolic disease. Less severe injuries can cause apathy, loss of concentration, and hypersomnia (sleep so long or so deep that the patient can only be awakened by forceful stimulation). Delirium is also a state in which arousal and attention are impaired; dementia is a severe cognitive dysfunction, usually not accompanied by impairment of arousal. Recent onset of confusion, severe apathy, rigidity, or coma suggest dysfunction of the cerebral hemispheres, mesencephalon, and/or upper brainstem. Focal lesions of supratentorial structures can extensively damage both cerebral hemispheres and can also cause brainstem injury through severe cerebral edema that compresses the hemispheric structures into the activating system of the mesencephalon and midbrain, causing brainstem herniation through the tracts of the cerebellar vermis. Primary subcerebellar (brainstem or cerebellar) lesions can compress or directly damage the reticular formation anywhere between the midbrain and the mesencephalon (via upward compression). Metabolic or infectious diseases can inhibit hemispheric and brainstem function through alterations in blood composition or the direct presence of toxins. Decreased cerebral blood flow (e.g., syncope or severe heart failure) or altered electrical activity of the brain (e.g., seizures) can also cause impairment of consciousness. Concussions, anxiolytic drugs, and anesthetics can cause impaired consciousness without detectable structural changes in the brain. The cause of impaired consciousness is often not immediately clear, and diagnosis depends on a sequential approach. First, the patient’s airway should be kept open; blood pressure and pulse should be checked, and an electrocardiogram should be performed to determine if the cardiac output is adequate. Symptomatic treatment The cause of the stiffness should be determined as soon as possible, and then appropriate treatment should be given for the cause or the different types of stiffness: 1. If the patient is not suitable for electroconvulsive therapy, intravenous injection of sulpiride 200-400mg/day can be used. 2, depressive wood stiffness: the best way to lift is also electroconvulsive therapy. Antidepressants should be given when the patient can be given orally. 3, psychogenic wood stiffness: It can be relieved by itself, and generally does not require special treatment. Benzodiazepines or small doses of antipsychotics with sedative effect can also be given. 4.Organic xylopathy: Treatment of different organic causes, such as anti-infection, surgical removal of tumor or hematoma, etc. Supportive therapy Patients with xylopathy mostly have difficulty in eating, so they need to be placed with a gastric tube from which fluids and nutrition are supplemented.