Poisoning the Mind Flashcards
what is feral alcohol syndrome
serious developmental disorder caused by prenatal alcohol exposure of the fetus
3 features of FAS
- Prenatal and/or postnatal growth retardation
- Central nervous system dysfunction
- Characteristic craniofacial abnormalities
symptoms of heavy drinking
Insomnia Depression Anxiety Attempted suicide/suicide Changes in personality Amnestic syndrome (korsakoff syndrome) Dementia Delirium tremens Alcohol hallucinosis Association with other addictions
Agnosia
cannot recognise familiar things
Aphasia
circumlocutions, cliches, circumstantiality
Apraxia
senses intact, understand what asked, physically able to do it but still cant do it
consequences of loss of executive functioning
Poor planning and organising of simple actions into more complicated sequences of action very poor adaptability. OK in familiar place but cannot cope with change in circumstance or surroundings, dependent on the familiar
what is dementia
Must be decline from previous level Must be memory loss At least one of these agnosia aphasia apraxia
what is chronic phase of Wenicke - Korsakoff syndrome
Korsakoff’s disease (amnesic syndrome)
4 symptoms of Wenicke - Korsakoff syndrome
- Confusion
- Eye symptoms = game paralysis, nystagmus
- Gait ataxia
- Neuropathological lesions: Lesions along the neural axis, particularly close to the ventricle wall
4 differential diagnosis of hepatic encephalopathy
- Metabolic encephalopathies - drugs/toxins
- Intracranial structural disorders - infection
- Seizures - Wernickes encephalopathy
- Head injury
other factors causing cognitive impairment WITH alcohol misuse
Intoxication Seizures Alcohol neurotoxicity Vitamin deficiency- particularly vitamin B1/thiamine Hypoglycaemia Head injury Cerebrovascular accidents Withdrawal delirium Hepatic encephalopathy Hypoxia Non-alcohol related cerebral pathology in older people
daily requirement of thymine
1-2mg
total body
30mg
Alcohol related brain damage causes
Neuropathies
Cerebellar degeneration
Dementia
Wernicke - forsakoff syndrome / amnestic syndrome
Nutritional/thyiamine deficiency symptoms
Weight loss in the past year
Reduced BMI
High carbohydrate intake
Recurrent episodes of vomiting
Amnesic syndrome/ Korsakoff syndrome
A syndrome associated with chronic prominent loss of recent memory; remote memory is sometimes impaired ,while immediate recall is preserved. Disturbances of time sense and ordering of events are usually evident, as are difficulties in learning new material.
Precipitating factors of hepatic encephalopathy
Increased protein load eg upper GI haemorrhage
Decreased excretion of ammonia eg renal failure
Others electrolyte disturbance
Dehydration, paracentesis, creation of portacaval shunts, infection, drugs, superimposed acute liver injury
factors affecting alcohol tolerance in relation to aging
decreased total body water
decrease in gastric alcohol dehydrogenase increases BAC
liver oxidation decreases
sensitivity of the brain to alcohol
what does encephalopathy indicate
liver failure
Non-alcohol related form of Wernicke-Korsakoff syndrome
due to thiamine depletion
combination of which 2 factors can lead to cortical and subcortical brain damage
cortical (alcohol-induced)
sub-cortical (alcohol and thiamine depletion induced)
2 important compounds in the pathogenesis of
ammonia and glutamate-glutamine cycle
how is there an increase in osmotic stress and astrocyte glutamine in hepatic encephalopathy
Blood-brain barrier more permeable to ammonia with down regulation of glutamate receptors and uptake
