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Delirium Dementia  Organic Amnestic Syndrome Other Organic Mental Disorders
Organic – due to  ,[object Object],[object Object],Suspicion of organic mental disorder  :  1.  First Episode  2 . Sudden Onset  3 . Older Age at onset  4 . Hx of Drug/Alcohol abuse  5.  Concurrent medical/neurological problem  6.  Neurological signs: Seizures, LOC, Head injury, sensory motor deficit.  7.  Presence of Confusion/Disorientation  8.  Presence of visual and non auditory (olfactory, gustatory, tactile) hallucinations
A. DELIRIUM ,[object Object],[object Object],[object Object]
Clinical Features ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],DECREASE AWARENESS TO SURROUNDING DECREASE ABILITY TO RESPOND TO ENVIRONMENTAL STIMULI ILLUSIONS HALLUCINATIONS Mostly Visual INSOMNIA DAY TIME SLEEPINESS
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],IMPAIRED IMMEDIATE RECALL IMPAIRED RECENT MEMORY SLURRING of SPEECH INCOHERANCE
Predisposing Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Organic ETIOLOGY of Delirium CLASS ETIOLOGY METABOLIC Hypoxia, Anemia, Electrolyte disturbance, Hepatic&Uremic Encephalopathy, Cardiac failure,arrest,arrythmia, Hypoglycemia, Metabolic acidosis&alkalosis, Shock ENDOCRINAL Pituitary, Thyroid, Parathyroid, Adrenal dysfunctions DRUG/SUBSTANCE (Many) including alcohol, benzodiazepines, anticholinergics, psychotropics, lithium, AntiHPT, diuretics, anticonvulsant, digoxin, heavy metals, Insulin, salicylates NUTRITIONAL DEFICIENCIES Thiamine, Niacine, Pyridoxine, Folic Acid INFECTIONS (ACUTE/CHRONIC) Septicemia, Pneumonia, Endocarditis, UTI, Meningitis, Encephalitis, Cellulitis INTRACRANIAL Stroke, Post Ictal, Head Injury, Infections, Migraine, Focal abscess/neoplasms, Hypertensive Encephelopathy MISCELLANEOUS Post op, ICU, Sleep deprivation
Management of Delirium ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],MAINTAIN WITH ORAL HALOPERIDOL, LORAZEPAM TILL RECOVERY IN 1 WEEK REVIEW DOSE, TAPER AND STOP
DELIRIUM VS DEMENTIA
B. DEMENTIA
[object Object]
CLINICAL FEATURES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Types and causes Of Dementia Commonest: ALZHEIMERS DEMENTIA, MULTIINFARCT DEMENTIA, HYPOTHYROID DEMENTIA, AIDS DEMENTIA COMPLEX TYPE CAUSES Parenchymatous Brain Disease Alzheimers Disease, Parkinson’s disease, Huntingtons’s Chorea, Pick’s Disease, Steel-Richardson syndrome (prog. Supranuclr palsy) Vascular Dementia Multiinfarct Dementia, Subcortical Vascular dementia (Binswanger’s disease) Toxic Dementia Alcohol, Drugs, Heavy Metals, Bromide, CO, Benzodiazepines, Psychotropics Metabolic Dementia Chronic hepatic/uremic encephalopathy, dialysis dementia, Wilson’s disease Endocrinal Pituitary, Parathyrois, Thyroid, Adrenal dysfunction Deficiency Dementia Pernicious anemia, Pellagra, Folic acid, Thiamine deficiency Infections AIDS, Neurosyphillis, Chronic Meningitis, Creutzfelft-Jacob disease  IOP ↑ Brain tumor, Headinjury hematoma, hydrocephalus
ALZHEIMER’S DEMENTIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MULTI INFARCT DEMENTIA ,[object Object],[object Object],[object Object],[object Object],[object Object],TIA HPT CVS DISEASE PREVIOUS STROKE
AIDS DEMENTIA COMPLEX ,[object Object],[object Object],[object Object],[object Object],[object Object]
MANAGEMENT OF DEMENTIA ,[object Object],[object Object],[object Object],[object Object],[object Object]
C. ORGANIC AMNESTIC SYNDROME ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management ,[object Object]
D. Other Organic Mental Disorders ,[object Object],[object Object],[object Object],[object Object]
Organic Hallucinosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Organic Catatonic Disorder ,[object Object],[object Object],[object Object],[object Object],[object Object]
Management  ,[object Object],[object Object]
Organic delusional disorder ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object]

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Organic Mental Disorders

  • 1. Delirium Dementia Organic Amnestic Syndrome Other Organic Mental Disorders
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7. Organic ETIOLOGY of Delirium CLASS ETIOLOGY METABOLIC Hypoxia, Anemia, Electrolyte disturbance, Hepatic&Uremic Encephalopathy, Cardiac failure,arrest,arrythmia, Hypoglycemia, Metabolic acidosis&alkalosis, Shock ENDOCRINAL Pituitary, Thyroid, Parathyroid, Adrenal dysfunctions DRUG/SUBSTANCE (Many) including alcohol, benzodiazepines, anticholinergics, psychotropics, lithium, AntiHPT, diuretics, anticonvulsant, digoxin, heavy metals, Insulin, salicylates NUTRITIONAL DEFICIENCIES Thiamine, Niacine, Pyridoxine, Folic Acid INFECTIONS (ACUTE/CHRONIC) Septicemia, Pneumonia, Endocarditis, UTI, Meningitis, Encephalitis, Cellulitis INTRACRANIAL Stroke, Post Ictal, Head Injury, Infections, Migraine, Focal abscess/neoplasms, Hypertensive Encephelopathy MISCELLANEOUS Post op, ICU, Sleep deprivation
  • 8.
  • 9.
  • 12.
  • 13.
  • 14.
  • 15. Types and causes Of Dementia Commonest: ALZHEIMERS DEMENTIA, MULTIINFARCT DEMENTIA, HYPOTHYROID DEMENTIA, AIDS DEMENTIA COMPLEX TYPE CAUSES Parenchymatous Brain Disease Alzheimers Disease, Parkinson’s disease, Huntingtons’s Chorea, Pick’s Disease, Steel-Richardson syndrome (prog. Supranuclr palsy) Vascular Dementia Multiinfarct Dementia, Subcortical Vascular dementia (Binswanger’s disease) Toxic Dementia Alcohol, Drugs, Heavy Metals, Bromide, CO, Benzodiazepines, Psychotropics Metabolic Dementia Chronic hepatic/uremic encephalopathy, dialysis dementia, Wilson’s disease Endocrinal Pituitary, Parathyrois, Thyroid, Adrenal dysfunction Deficiency Dementia Pernicious anemia, Pellagra, Folic acid, Thiamine deficiency Infections AIDS, Neurosyphillis, Chronic Meningitis, Creutzfelft-Jacob disease IOP ↑ Brain tumor, Headinjury hematoma, hydrocephalus
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.

Notas del editor

  1. Fleeting: fast, fragmentary: small