Organic Mental Disorders

Question 1

What features suggest an organic cause of a mental disorder?

Answer 1

Memory defects
Other cognitive decline (learning, intellect)
Altered consciousness
Attention deficits

Question 2

What are the acute and chronic organic mental disorders?

Answer 2

Acute- delirium, organic mood disorder and organic psychotic disorder
Chronic- dementia, amnesiac syndrome and organic personality change

Question 3

What are the presenting features of delirium?

Answer 3

Impairment of consciousness and attention
Global disturbance of cognition
Psychomotor disturbance
Disturbance of sleep-wake cycle
Emotional disturbance
Rapid onset with duration <6 months and diurnal variation

Question 4

What are the features of hepatic encephalopathy?

Answer 4

Usually seen in advanced liver disease and is associated with general psychomotor retardation, drowsiness, fluctuating confusion and a flapping tremor

Question 5

What are the features of amnesiac syndrome?

Answer 5

A syndrome of recent and remote memory. Immediate recall is preserved but new learning is reduced and anterograde amnesia present. Patients are often disorientated in time and retrograde amnesia may also be present but usually recedes with tine

Question 6

Where are the possible locations of lesions causing amnesiac syndrome?

Answer 6

Either the hypothalamic-diencephalic system or the hippocampal region

Question 7

What are the potential .hypothalamic-diencephalic system causes of amnesiac syndrome?

Answer 7

Korsakoff’s syndrome (most common)
3rd ventricle tumours and cysts
Bilateral thalamic infarction
Post subarachnoid haemorrhage

Question 8

What are the possible hippocampal causes of amnesiac syndrome?

Answer 8

Herpes simplex virus encephalitis
Anoxia
Surgical removal of temporal lobes
Bilateral posterior cerebral artery occlusion
Closed head injury
Early Alzheimer’s disease