Kshirabdhi Tanaya MHN Tutor,SUM nursing college,SOA DTU ,BBSR

1. PRESENTED BY:
Kshirabdhi Tanaya
MHN Tutor,SUM nursing
college,SOA DTU ,BBSR

2. INTRODUCTION
Organic brain disorder is a disorder of mental
function ,in which psychological dysfunction
happens due to the damage occurred in brain.
There are 2 main causes of organic brain
disorders are :
brain injury and diseases that affect brain.

3. Definition
A neuropsychiatric disorder which has a
strong biological basis or a significant
brain dysfunction.

4. ICD-10 CLASSIFICATION OF ORGANIC MENTAL
DISORDER
F00-F09:- Organic , including symptomatic
mental disorders
F00- Dementia in Alzheimer’s disease
F01-Vascular dementia
F02- Dementia in other diseases
F03-Unspecified Dementia
F04- Organic Amnestic Syndrome
F05-Delirium
F06-Other mental disorders due to brain damage
and dysfunction and physical disease
F07-Personality and behavioural disorders due
to brain disease , damage and dysfunction

5. Etiology of organic brain disorder
1.PRIMARY CAUSES:-
Intracranial causes:
Epilepsy
Head injury
Infection
Encephalitis
Subarachnoid hemorrhage
Migraine
Stroke
Focal lesions

6. 2.SECONDARY CAUSES:
a. Metabolic causes:
Hypoxia
Hepatic encephalopathy
Hypoglycemia
Cardiac arrythmia
Metabolic acidosis
Water and electrolyte imbalance
Hypovolemic shock
Anaemia

7. b. Endocrine causes:
Increased /decreased level of hormones of
glands ie
•Pituitary
•Thyroid
•Parathyroid
•Adrenal
c. Nutritional deficiency
Thiamine
Folic acid
Niacin
pyridoxine

8. d. Systemic infections:
•Septicemia
•Endocarditis
•Pneumonia
e. Drugs:
Antihypertensive
Anticonvulsants
Digitalis
Antidepressants
Anxiolytics
Antipsychotics
Hypnotics/sedatives

9. DELIRIUM

10. DEFINITION
Delirium is a mental state characterized by a
disturbance of cognition, which is manifested by
confusion, excitement, disorientation, and a
clouding of consciousness. Hallucinations and
illusions are common.
A delirium is characterized by a disturbance in
attention and awareness and a change in
cognition that develop rapidly over a short period
(APA, 2013).

11.  Prevalence rates from 10-30% of patients
 In nursing homes, prevalence reaching 60% of
those older than the age of 75 years
 Occurs in 30% of hospitalized cancer patients
 30-40% of those hospitalized with AIDS
 Higher for women than men
 Common in elderly, post-surgical patients

12. Systemic infections
Febrile illness
Metabolic disorders, such as hypoxia,
hypercarbia(hypercapnia), or
hypoglycemia
Hepatic encephalopathy
Head trauma
Seizures

13. Contd…..
Migraine headaches
Brain abscess
Stroke
Postoperative states
Electrolyte imbalance
Imbalance of neurotransmitter
Medications

14. ETIOLOGY
I - Infections (UTI , pneumonia, Septicemia,
endocarditis)
W - Withdrawal (Opioids , Alcohol)
A – Acute metabolic (Acidosis/alkalosis,
Renal failure)
T-Trauma
C- CNS pathology (Epilepsy , head injury,
encephalitis , cerebral haemorrhage,
migraine, stroke , focal lesion)
I WATCH DEATH

15. H- Hypoxia
D-Deficiencies (Cyanocobalamine , thiamine,
folic acid, niacin, pyridoxine)
E-Endocrine (Thyroid, parathyroid, pituitary,
Adrenal)
A- Acute Vascular (Stroke, MI, Pulmonary
embolism, heart failure)
T- Toxin/Drugs (Tramadol, digoxin toxicity,
sedatives, anxiolytics, antihypertensives,
anticonvulsants, furosemide,
antidepressants,corticosteroids etc
H- Heavy Metals (mercury, cadmium, lead etc)

16. TYPES OF DELIRIUM
1.HYPOACTIVE DELIRIUM
Patient will have intermittent sleep through out the
day.
Patient will also have inattention while awake
Patient may fall into sleep very soon.
Patient might miss medications / appointments
/meals .
2.HYPERACTIVE DELIRIUM
patient will be highly active due to response of
increased internal stimuli.

17. 3.MIXED DELIRIUM
It is a combination of both hypoactive and
hyperactive forms. Majority of elders with
delirium i.e 80% belong to mixed and
hypoactive type.

22. Clinical manifestations
Acute onset(less than 6months)
Clouding of consciousness
Disorientation
Perceptional
disturbances(illusions/hallucinations)
Sleep wake cycle
Sun downing syndrome
Memory disturbances

23. Speech disturbances
mood alteration
Agoraphobia
Aimless activities like picking at the bed
clothes (flocculation), blindly search
something with the hand}
Hypo/hyper activity
Depression
Anxiety
Euphoria
Irritability
Apathy
Fear

24. DIAGNOSIS
•History collection
•Interview: It focuses on
concentration, mood lability, memory
deficits etc
•Confusion assessment method (CAM)
•CT scan/MRI
•Miscellaneous : CBC , urine analysis,
ECG,EEG

25. TREATMENT
Antipsychotics: Haloperidol 0.5 - 1 mg,
Risperidone 0.5-2mg, Quetiapine 12.5 - 50
mg, olanzapine 2.5 -10mg
Benzodiazepine: Lorazepam 0.5 -1 mg
Physostigmine
Music therapy/light therapy to normalize
the sleep- wake cycle

26. DEMENTIA IN ALZHEIMER’S DISEASE
Dementia is an acquired global
impairment of intellect ,memory and
personality but without impairment of
consciousness.
Alzheimer’s type dementia is an
irreverssible disese marked by
global,progressive impairment of
cognitive functioning ,memory , and
personality

27. Etilogy