organic disorders Flashcards
organic disorder def
mental disorder due to common demonstrable aetiology of cerebral disease, brain injury or other insult leading to cerebral dysfunction
1ry vs 2ry organic disorder
1ry: direct effect on brain
2ry: systemic disease that affects brain in addition to other organs
common features organic disorders
cognitive: memory, learning, intellect
mood: depressed, anxiety, elevation
psychotic: hallucination, delusion
personality + behavioural disturbance
sensorium: consciousness, attention
acute/subacute organic disorders
delirium
organic mood disorder
organic psychotic disorder
chronic organic disorder
dementia
amnesic syndrome
organic personality change
delirium tremens
complicate acute alcohol withdrawal
impaired memory, hallucinatinos, confusion
Rx benzodiazepines
wernicke’s encephalopathy
acute confusional state
ataxia
nystagmus
opthalmoplegia
acute thiamine deficiency
korsakoff’s
imapaired anterograde memory
personality changes, apathy, loss initiative
confabulation
hepatic encephalopathy
advanced alcohol liver disease, due to build up of toxins
psychomotor retardation, drowsy, confusion
alcohol related brain damage
spectrum of alcohol related medical disorders
cog impairment when sober: short term memory, long-term recall, new skill acquisition
causes of alcohol related brain damage
neurotoxic effects of alcohol head injury vitamin deficiencies cerebrovascular disease hypoxia hypoglycaemia
alcohol related brain damage signs on imaging
cortical atrophy
ventricular enlargement
adults w incapacity: incapable of
acting making decisions communicating decisions understanding decisions retain memory of decisions
dementia
chronic global cognitive impairment
usually progressive
types of dementia
vascular alzheimer's mixed lewy body frontotemporal
2ry: huntingtons, head injury, parkinsons
dementia general features
progressive onset
longterm symptomology
constant cog decline
depressive pseudodementia features
rapid onset
short term symptomology
fluctuating cog decline
depressed mood
steroid induced psychosis
dosage related to incidence but not to timing, duration or severity
subsequent events not predicted by previous reactions
consider tapering steroids
consider anti-psychotic, mood stabiliser
anti-NMDA receprot encephalitis
autoimmune disease that targets NMDA receptors
presents initially w psychiatric symptoms e.g. psychosis
rx w immunotherapy: IV Ig, plasmapharesis, rituximab
NMDA receptor
ionotropic glutamate receptor involved in synaptic plasticity and memory function
delirium features
impaired consciousness and attention global disturbance cognition psychomotor disturbance disturbance sleep wake cycle emotional disturbance
delirium characteristics
rapid onset
diuranally fluctuating
<6mo
delirium causes
medications: anticholinergic durgs drug abuse: cocaine withdrawal: alcohol metabolic: hypoglycaemia, uraemia vitamin def.: thiamine, B12 endocrinopathies infections head injury, stroke SLE
