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Li Meixiu (Ellen) : JMS University
Li Meixiu (Ellen) : JMS University
Li Meixiu (Ellen) : JMS University
JMS University
Chapter 3. organic--symptomatic ,mental disorder
Psychiatry disorder
• Organic cause
• Organic causation not be found
• Psychological factors
• First episode
• Sundden onset
• Older age of onset
• History of drug & / alcohol use disorder
• Concurrent medical / neurological illness
• Neurological symptoms / signs
• Confusion / disorientation / memory impairment /
soft neurological signs
• Visual / non–auditory hallucination
• Delirium
• Dementia
• Organic amnestic syndrome
• Other organic mental disorders
•
Delirium
• A disorder --;
• Neoplastic :
• Traumatic :chronic subdural hematoma
• Hydrocephalic
Cortical dementias
• Alzheimer's disease
• Vascular dementia (multi-infarct dementia), Binswanger's disease
• Dementia with Lewy bodies (DLB)
• Alcohol-Induced Persisting Dementia
– Korsakoff's syndrome
– Wernicke's encephalopathy
• Frontotemporal lobar degenerations (FTLD), including Pick's disease
– Frontotemporal dementia (or frontal variant FTLD)
– Semantic dementia (or temporal variant FTLD)
– Progressive non-fluent aphasia
• Creutzfeldt-Jakob disease
• Dementia pugilistica
• Moyamoya disease
• Thebestia (Often mistaken for a cancer)
• Posterior cortical atrophy or Benson's syndrome.
Subcortical dementias
Rather, people with subcortical dementias, such as Huntington's disease,
Parkinson's Disease, and AIDS dementia complex, tend to show
changes in their personality and attention span, and their thinking
slows down.
• Dementia due to Huntington's disease
• Dementia due to Hypothyroidism
• Dementia due to Parkinson's disease
• Dementia due to Vitamin B1 deficiency
• Dementia due to Vitamin B12 deficiency
• Dementia due to Folate deficiency
• Dementia due to Syphilis
• Dementia due to Subdural hematoma
• Dementia due to Hypercalcaemia
• Dementia due to Hypoglycemia
• AIDS dementia complex
• Pseudodementia (a major depressive episode with prominent cognitive symptoms)
Substance-induced persisting dementia
Management
• Basic investigation
• Treatment of the underlying causes
• Symptomatic management
• Medications : AChE inhibitors Tacrine (Cognex),
donepezil (Aricept), galantamine (Razadyne), and
rivastigmine (Exelon )
Contraindicated
Antipsychotic drugs
• typical antipsychotics (such as Haloperidol) &
atypical antipsychotics (risperidone) increases the
risk of death in dementia-associated psychosis
organic amnestic syndrome
• Impairment of memory
• consciousness & attention
• Intellectural function
inability to learn new material
Diagnosis & differential diagnosis
Etiology
• Thiamin deficiency
• Lesion involving bilaterally the inner core of limbic
system: hypoxia, post. Cerebral a. stroke
• Herpes simplex encephalitis
• Space occupying lesions in the region of Ⅲ ventricle
Organic hallucinosis
• Persistent / recurrent hallucination
• Consciousness ,intelligence ,memory ,mood /
thought
Etiology
• Drugs :hallucinogens-LSD , psilocybin ,cocaine
• Alcohol : auditory hallucination
• Sensory deprivation
• Release hallucination : sensory pathway optic neuritis
• Migraine
• Epilepsy
• Intracranial spae occupying lesions
• Temporal arteritis
• Brain stem lesions (peduncular hallucinosis )
Organic catatonic disorder
• A neuropsychiatric disorder : immobility, mutism,
negativism , mannerisms, stereotypies, posturing,
grimacing, excitement, echolalia, echopraxia,
muscular rigidity, stupor; sudden violent outbursts,
panic, or hallucinations.
• α
• β
• γ malignant
• δ controlled
• ε dipsomania / spree-drinking(episodic heavy
consumption in uncontrolled binges )
complications
• Acute intoxication
• Withdrawal syndrome
• Delirium tremens
• Alcoholic seizures
• Alcoholic hallucinosis
Self -discipline