Organic Disorders Flashcards
What an organic brain disorder?
Mental disorder due to common, demonstrable cause of cerebral disease, brain injury or other insult
Either primary or secondary
What are the clusters of symptoms of organic brain disease?
Cognitive (memory, intellect0 Sensorium (consciousness, attention) Mood Psychosis Later onset, progressive
What are the different types of organic mental disorders?
Acute/subacute - Delirium - Organic mood/psychosis disorder Chronic - Dementia - Amnesiac syndrome
How is Delirium characterised?
Concurrent disturbances of consciousness, perception, thinking, memory, psychomotor, emotion
What are the presenting features of delirium?
- Impairment of consciousness and attention
- Global disturbance of cognition
- Psychomotor disturbances
- Disturbance of sleep-wake cycle
- Emotional disturbance
Rapid onset with diurnal fluctuation, <6 months
How is delirium managed?
Treat underlying cause Supportive measures: - Safe environment - Optimise stimulation - Educate relatives, med staff Correct contributing factors Avoid sedation Antipsychotics, Benzos, Promethazine
What is the medical management of delirium?
AVOID sedation
Benzos
Antipsychotics
Promethazine
How does Hepatic Encephalopathy present?
General psychomotor retardation Drowsiness Fluctuating confusion Asterixis (Build up of toxic products - ammonia)
How does Amnesic syndrome present?
Impairment of recent and remote memory Immediate recall preserved New learning reduced Anterograde amnesia Disorientation in time Retrograde amnesia Confabulation Perception and other cognitive functions preserved
What are the main types of Amnesic syndrome?
Diencephalic damage
Hippocampal damage
What causes Diencephalic Amnesic syndrome?
Korsakoff’s syndrome
3rd ventricle tumours
Bilateral thalamic infarction
What causes Hippocampal Amnesic syndrome?
HSV encephalitis
Anoxia
Head injury
Early alzheimers
What is the management of amnesic syndrome?
Fix cause
Thiamine in alcoholism
