Organic brain syndrome

Last updated
Organic brain syndrome
Other names
  • Organic brain disease
  • Organic brain disorder
  • Organic mental syndrome
  • Organic mental disorder
Chronic Traumatic Encephalopathy.png
Encephalopathy as a result of head trauma,possible cause of organic brain syndrome
Specialty Psychiatry, Neurology
Symptoms Depends on the cause,usually memory problems, personality changes, mood swings, cognitive impairment, vision and movement problems [ medical citation needed ]
Usual onsetOver 60 years old
CausesOrgan damage,generally of the brain
Risk factors Head trauma, intoxication with certain substances, infection, vitamin deficiency [ medical citation needed ]
Differential diagnosis Schizophrenia, bipolar disorder, post concussion syndrome, drug withdrawal

Organic brain syndrome, also known as organic brain disease, organic brain damage, organic brain disorder (OBD), [1] organic mental syndrome, or organic mental disorder, refers to any syndrome or disorder of mental function whose cause is alleged to be known as organic (physiologic) rather than purely of the mind. These names are older and nearly obsolete general terms from psychiatry, referring to many physical disorders that cause impaired mental function. [2] They are meant to exclude psychiatric disorders (mental disorders). Originally, the term was created to distinguish physical (termed "organic") causes of mental impairment from psychiatric (termed "functional") disorders, but during the era when this distinction was drawn, not enough was known about brain science (including neuroscience, cognitive science, neuropsychology, and mind-brain correlation) for this cause-based classification to be more than educated guesswork labeled with misplaced certainty, which is why it has been deemphasized in current medicine. While mental or behavioural abnormalities related to the dysfunction can be permanent, [3] treating the disease early may prevent permanent damage in addition to fully restoring mental functions. An organic cause to brain dysfunction is suspected when there is no indication of a clearly defined psychiatric or "inorganic" cause, such as a mood disorder. [4]

Contents

Types

Organic brain syndrome can be divided into 2 major subgroups: acute (delirium or acute confusional state) and chronic (dementia). A third entity, encephalopathy (amnestic), denotes a gray zone between delirium and dementia. The Diagnostic and Statistical Manual of Mental Disorders has broken up the diagnoses that once fell under the diagnostic category organic mental disorder into three categories: delirium, dementia, and amnestic. [4]

Delirium

Delirium or Acute organic brain syndrome is a recently appearing state of mental impairment, as a result of intoxication, drug overdose, infection, pain, and many other physical problems affecting mental status. In medical contexts, "acute" means "of recent onset". As is the case with most acute disease problems, acute organic brain syndrome is often temporary, although this does not guarantee that it will not recur or progress to become chronic, that is, long-term. A more specific medical term for the acute subset of organic brain syndromes is delirium. [5]

Dementia

Dementia or chronic organic brain syndrome is long-term. For example, some forms of chronic drug or alcohol dependence can cause organic brain syndrome due to their long-lasting or permanent toxic effects on brain function. [6] Other common causes of chronic organic brain syndrome sometimes listed are the various types of dementia, which result from permanent brain damage due to strokes, [7] Alzheimer's disease, or other damaging causes which are irreversible. Amnestic pertains to amnesia and is the impairment in ability to learn or recall new information, or recall previously learned information. Although similar, it is not coupled with dementia or delirium. [8]

Amnestic

Amnestic conditions denotes a gray zone between delirium and dementia; its early course may fluctuate, but it is often persistent and progressive. [9] Damage to brain functioning could be due not only to organic (physical) injury (a severe blow to the head, stroke, chemical and toxic exposures, organic brain disease, substance use, etc.) and also to non-organic means such as severe deprivation, abuse, neglect, and severe psychological trauma. [10]

Symptoms

Many of the symptoms of Organic Mental Disorder depend on the cause of the disorder, but are similar and include physical or behavioral elements. Dementia and delirium are the cause of the confusion, orientation, cognition or alertness impairment. [11] Therefore, these symptoms require more attention because hallucinations, delusions, amnesia, and personality changes are the result. These effects of the dementia and delirium are not joined with the changes of sensory or perception abilities. Memory impairment, judgment, logical function and agitation are also some extremely common symptoms. [12] The more common symptoms of OBS are confusion; impairment of memory, judgment, and intellectual function; and agitation. Often these symptoms are attributed to psychiatric illness, which causes a difficulty in diagnosis.

Associated conditions

Disorders that are related to injury or damage to the brain and contribute to OBS include, but are not limited to:

Other conditions that may be related to organic brain syndrome include: clinical depression, neuroses, and psychoses, which may occur simultaneously with the OBS.

Treatment

While the treatment depends on which particular disorder is involved in Organic Mental Disorder, a few that are possible. Treatments can include, but are not limited to, rehabilitation therapy such as physical or occupational, pharmacological modification of the neurotransmitter function, or medication. [18] The affected parts of the brain can recover some function with the help of different types of therapy, or tractographical psysurgery. Online therapy can be just as intense and helpful as rehabilitation therapy, in person, and can help those affected regain function in daily life. [19]

Prognosis

Some disorders are short-term and treatable, and their prognosis is not as lengthy. [20] Rest and medication are the most common courses of action for these treatable cases to help the patient return to proper health. Many of the cases are long-term, and there is not as much of a set and defined prognosis. The course of action can include extensive counseling and therapy. [21] There are many reasons that the long-term cases are harder to treat and these include these cases normally get worse over time, and medication or therapy could not work. [22] In this case, many of the prognosis tracks are to help the patient and their family become more comfortable and understand what will happen.

Associated conditions

Related Research Articles

<span class="mw-page-title-main">Dementia</span> Long-term brain disorders causing impaired memory, thinking and behavior

Dementia is a syndrome associated with many neurodegenerative diseases, characterized by a general decline in cognitive abilities that affects a person's ability to perform everyday activities. This typically involves problems with memory, thinking, behavior, and motor control. Aside from memory impairment and a disruption in thought patterns, the most common symptoms of dementia include emotional problems, difficulties with language, and decreased motivation. The symptoms may be described as occurring in a continuum over several stages. Dementia ultimately has a significant effect on the individual, their caregivers, and their social relationships in general. A diagnosis of dementia requires the observation of a change from a person's usual mental functioning and a greater cognitive decline than might be caused by the normal aging process.

Delirium is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days. As a syndrome, delirium presents with disturbances in attention, awareness, and higher-order cognition. People with delirium may experience other neuropsychiatric disturbances including changes in psychomotor activity, disrupted sleep-wake cycle, emotional disturbances, disturbances of consciousness, or, altered state of consciousness, as well as perceptual disturbances, although these features are not required for diagnosis.

<span class="mw-page-title-main">Vascular dementia</span> Dementia resulting from stroke

Vascular dementia is dementia caused by a series of strokes. Restricted blood flow due to strokes reduces oxygen and glucose delivery to the brain, causing cell injury and neurological deficits in the affected region. Subtypes of vascular dementia include subcortical vascular dementia, multi-infarct dementia, stroke-related dementia, and mixed dementia.

<span class="mw-page-title-main">Wernicke–Korsakoff syndrome</span> Combined presence of Wernickes encephalopathy (WE) and Korsakoffs syndrome

Wernicke-Korsakoff syndrome (WKS) is the combined presence of Wernicke encephalopathy (WE) and alcoholic Korsakoff syndrome. Due to the close relationship between these two disorders, people with either are usually diagnosed with WKS as a single syndrome. It mainly causes vision changes, ataxia and impaired memory.

Encephalopathy means any disorder or disease of the brain, especially chronic degenerative conditions. In modern usage, encephalopathy does not refer to a single disease, but rather to a syndrome of overall brain dysfunction; this syndrome has many possible organic and inorganic causes.

Drug withdrawal, drug withdrawal syndrome, or substance withdrawal syndrome is the group of symptoms that occur upon the abrupt discontinuation or decrease in the intake of pharmaceutical or recreational drugs.

Cognitive disorders (CDs), also known as neurocognitive disorders (NCDs), are a category of mental health disorders that primarily affect cognitive abilities including learning, memory, perception, and problem-solving. Neurocognitive disorders include delirium, mild neurocognitive disorders, and major neurocognitive disorder. They are defined by deficits in cognitive ability that are acquired, typically represent decline, and may have an underlying brain pathology. The DSM-5 defines six key domains of cognitive function: executive function, learning and memory, perceptual-motor function, language, complex attention, and social cognition.

Cerebral atrophy is a common feature of many of the diseases that affect the brain. Atrophy of any tissue means a decrement in the size of the cell, which can be due to progressive loss of cytoplasmic proteins. In brain tissue, atrophy describes a loss of neurons and the connections between them. Brain atrophy can be classified into two main categories: generalized and focal atrophy. Generalized atrophy occurs across the entire brain whereas focal atrophy affects cells in a specific location. If the cerebral hemispheres are affected, conscious thought and voluntary processes may be impaired.

<span class="mw-page-title-main">Confusion</span> State of being bewildered or unclear in ones mind about something

In medicine, confusion is the quality or state of being bewildered or unclear. The term "acute mental confusion" is often used interchangeably with delirium in the International Statistical Classification of Diseases and Related Health Problems and the Medical Subject Headings publications to describe the pathology. These refer to the loss of orientation, or the ability to place oneself correctly in the world by time, location and personal identity. Mental confusion is sometimes accompanied by disordered consciousness and memory loss.

Toxic encephalopathy is a neurologic disorder caused by exposure to neurotoxic organic solvents such as toluene, following exposure to heavy metals such as manganese, as a side effect of melarsoprol treatment for African trypanosomiasis, adverse effects to prescription drugs, or exposure to extreme concentrations of any natural toxin such as cyanotoxins found in shellfish or freshwater cyanobacteria crusts. Toxic encephalopathy can occur following acute or chronic exposure to neurotoxicants, which includes all natural toxins. Exposure to toxic substances can lead to a variety of symptoms, characterized by an altered mental status, memory loss, and visual problems. Toxic encephalopathy can be caused by various chemicals, some of which are commonly used in everyday life, or cyanotoxins which are bio-accumulated from harmful algal blooms (HABs) which have settled on the benthic layer of a waterbody. Toxic encephalopathy can permanently damage the brain and currently treatment is mainly just for the symptoms.

Psychoorganic syndrome (POS), also known as organic psychosyndrome, is a progressive disease comparable to presenile dementia. It consists of psychopathological complex of symptoms that are caused by organic brain disorders that involve a reduction in memory and intellect. Psychoorganic syndrome is often accompanied by asthenia.

Memory disorders are the result of damage to neuroanatomical structures that hinders the storage, retention and recollection of memories. Memory disorders can be progressive, including Alzheimer's disease, or they can be immediate including disorders resulting from head injury.

<span class="mw-page-title-main">Frontal lobe disorder</span> Brain disorder

Frontal lobe disorder, also frontal lobe syndrome, is an impairment of the frontal lobe of the brain due to disease or frontal lobe injury. The frontal lobe plays a key role in executive functions such as motivation, planning, social behaviour, and speech production. Frontal lobe syndrome can be caused by a range of conditions including head trauma, tumours, neurodegenerative diseases, neurodevelopmental disorders, neurosurgery and cerebrovascular disease. Frontal lobe impairment can be detected by recognition of typical signs and symptoms, use of simple screening tests, and specialist neurological testing.

Clouding of consciousness, also called brain fog or mental fog, occurs when a person is slightly less wakeful or aware than normal. They are less aware of time and their surroundings, and find it difficult to pay attention. People describe this subjective sensation as their mind being "foggy".

Alcohol-related dementia (ARD) is a form of dementia caused by long-term, excessive consumption of alcohol, resulting in neurological damage and impaired cognitive function.

Pseudodementia is a condition that leads to cognitive and functional impairment imitating dementia that is secondary to psychiatric disorders, especially depression. Pseudodementia can develop in a wide range of neuropsychiatric disease such as depression, schizophrenia and other psychosis, mania, dissociative disorders, and conversion disorders. The presentations of pseudodementia may mimic organic dementia, but are essentially reversible on treatment and doesn't lead to actual brain degeneration. However, it has been found that some of the cognitive symptoms associated with pseudodementia can persist as residual symptoms and even transform into true neurodegenerative dementia in some cases.

Sundowning, or sundown syndrome, is a neurological phenomenon associated with increased confusion and restlessness in people with delirium or some form of dementia. It is most commonly associated with Alzheimer's disease but is also found in those with other forms of dementia. The term sundowning was coined by nurse Lois K. Evans in 1987 due to the timing of the person's increased confusion beginning in the late afternoon and early evening. For people with sundown syndrome, a multitude of behavioral problems begin to occur and are associated with long-term adverse outcomes. Sundowning seems to occur more frequently during the middle stages of Alzheimer's disease and mixed dementia and seems to subside with the progression of the person's dementia. People are generally able to understand that this behavioral pattern is abnormal. Research shows that 20–45% of people with Alzheimer's will experience some variation of sundowning confusion. However, despite lack of an official diagnosis of sundown syndrome in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), there is currently a wide range of reported prevalence.

<span class="mw-page-title-main">Neurological disorder</span> Any disorder of the nervous system

A neurological disorder is any disorder of the nervous system. Structural, biochemical or electrical abnormalities in the brain, spinal cord or other nerves can result in a range of symptoms. Examples of symptoms include paralysis, muscle weakness, poor coordination, loss of sensation, seizures, confusion, pain, tauopathies, and altered levels of consciousness. There are many recognized neurological disorders, some are relatively common, but many are rare.

<span class="mw-page-title-main">Impact of COVID-19 on neurological, psychological and other mental health outcomes</span>

There is increasing evidence suggesting that COVID-19 causes both acute and chronic neurologicalor psychological symptoms. Caregivers of COVID-19 patients also show a higher than average prevalence of mental health concerns. These symptoms result from multiple different factors.

References

  1. Patel, Beejal M; Ghosh, Sanjukta S; Vora, Vaishal N; Lakdawala, Bhaveshkumar M (Oct–Dec 2023). "Organic Brain Disorders Manifesting as Psychiatric Symptoms". Annals of Indian Psychiatry. 7 (4): 375–377. doi: 10.4103/aip.aip_182_2 (inactive 1 November 2024). Retrieved 31 October 2024.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  2. "MedlinePlus Medical Encyclopedia: Organic brain syndrome" . Retrieved 2009-02-27.
  3. "Organic mental disorders". Depression-guide.com. Retrieved 2012-10-12.
  4. 1 2 "Organic Psychosis - Medical Disability Guidelines". Mdguidelines.com. Archived from the original on 2013-07-08. Retrieved 2012-10-12.
  5. "acute organic brain syndrome" at Dorland's Medical Dictionary
  6. 1 2 Luderer HJ, Schulz M, Mayer M (November 1995). "[Long-term administration of benzodiazepines--disease follow-up, sequelae, treatment. A retrospective clinical record evaluation of 194 patients]". Psychiatr Prax (in German). 22 (6): 231–4. PMID   8570753.
  7. Kuźma, Elżbieta; Lourida, Ilianna; Moore, Sarah F.; Levine, Deborah A.; Ukoumunne, Obioha C.; Llewellyn, David J. (August 2018). "Stroke and dementia risk: A systematic review and meta-analysis". Alzheimer's & Dementia. 14 (11): 1416–1426. doi:10.1016/j.jalz.2018.06.3061. hdl:2027.42/152961. ISSN   1552-5260. PMC   6231970 . PMID   30177276.
  8. "Amnestic".
  9. "Delirium, Dementia, and Amnesia in Emergency Medicine". Misc.medscape.com. Retrieved 2012-10-12.
  10. "Differences between psychological and neuropsychological evaluation". www.bgcenter.com. Archived from the original on 2012-05-09. Retrieved 2012-10-12.{{cite web}}: CS1 maint: bot: original URL status unknown (link)
  11. "What are the Symptoms of Organic Mental Disorder?". 31 January 2015.
  12. "Benefits For Organic Mental Disorders".
  13. Martin PR, Adinoff B, Weingartner H, Mukherjee AB, Eckardt MJ (1986). "Alcoholic organic brain disease: nosology and pathophysiologic mechanisms". Prog. Neuropsychopharmacol. Biol. Psychiatry. 10 (2): 147–64. doi:10.1016/0278-5846(86)90069-2. PMID   2875490. S2CID   8128954.
  14. 1 2 3 "ICD-10 Version:2008".
  15. Rogers, M. P; Bloomingdale, K; Murawski, B. J; Soter, N. A; Reich, P; Austen, K. F (1986). "Mixed organic brain syndrome as a manifestation of systemic mastocytosis". Psychosomatic Medicine. 48 (6): 437–47. doi:10.1097/00006842-198607000-00006. PMID   3749421. S2CID   37335288.
  16. "Organic brain syndrome". MedlinePlus.
  17. Khan A, Joyce P, Jones AV (August 1980). "Benzodiazepine withdrawal syndromes". N. Z. Med. J. 92 (665): 94–6. PMID   6107888.
  18. Martin, P. R.; Eckardt, M. J.; Linnoila, M. (1989). "Treatment of Chronic Organic Mental Disorder". Recent Developments in Alcoholism. 7: 329–50. doi:10.1007/978-1-4899-1678-5_17. PMID   2648495.
  19. "Treatment for Organic Mental Disorders". Archived from the original on 2019-04-16. Retrieved 2019-12-20.
  20. 1 2 "Organic brain syndrome: MedlinePlus Medical Encyclopedia". Nlm.nih.gov. Retrieved 2012-10-12.
  21. "Organic Mental Disorders". Archived from the original on 2019-04-16. Retrieved 2019-12-20.
  22. "Getting Treatment for Organic Mental Disorder". 31 January 2015.
  23. Evans, Larry (1970-01-01). "A Case of Lithium Poisoning?, Australian and New Zealand Journal of Psychiatry, Informa Healthcare". Australian & New Zealand Journal of Psychiatry. 12 (2): 133–135. doi:10.3109/00048677809159607. PMID   278604. S2CID   22843465.