Gffff

1. ORGANIC
MENTAL
DISORDERS
GADELRAB MOHAMED
MOHAMED
GROUP : 505A

2. Definition

3. THERE ARE
TWO MAJOR
CATEGORIES
OF
O.M.D

4. ETIOLOGY
OF
ORGANIC
MENTAL
DISORDERS

5. DELIRIUM
• Definition
• Delirium is an acute
reversible state of global
cortical dysfunction
characterized by
• disturbance of
consciousness. * It is
associated with global
impairment of cognitive
functions as well as other
mood
• and behavioral changes.

6. CLINICAL FEATURES
OF DELIRIUM
• 1. Disturbance of consciousness
* 2. Global disturbance of
cognitive functions
• including:
• a. Attention
• b. Memory
• c. Perception
• d. Orientation
• 3. Other manifestations:
• a. Emotional disturbance
• b. Psychomotorbehave
• c. Sleep-wake cycle

7. ETIOLOGY
• 1. Head trauma
• 2. Metabolic and endocrine
disorders
• 3. Substance related
• 4. Medication induced
• 5. Toxins
• 6.Severe anemia and vitamin
deficiency
• 7. Postsurgicalconditions
• 8. Infections
• 9. Cerebrovascular strokes
10. Epilepsy
11.Multifactorial

8. MANAGEMENT OF
DELIRIUM
• 1- Treatment of the cause
• 2- Supportive measures × 3-
Providing optimum sensory
• environment *4-
Symptomatic treatment for
anxiety, agitation or
psychotic
• symptoms

9. DEMENTIA
• Definition A syndrome
characterized by multiple
cognitive defects including
disturbance of memory,
without disturbance of
• consciousness. The syndrome
results from organic diseases
of the brain that are usually of
• a chronic and progressive
nature.

10. Clinical
fractures of
dementia
• 1. Multiple cognitive defects:
• a. Memory impairment:
• b. Other cognitive disturbances: Aphasia, Apraxia, Agnosia
• Disturbance of executive functions
• Disturbed attention, perception and orientation
• 2. Associated deterioration of other functions:
• a. Impaired emotional control
• b. Depression and anxiety
• c. Impairment of judgment
• d. Psychotic symptoms
• * 3. Associated neurological manifestations:
• a. Usually late
• b. Various sensorv and motor manifestations
• c. incontinence and bedridden.

11. Etiology of
dementia
• 1. Degenerative diseases:
• a. Alzheimer's disease
• b. Pick's disease
• c. Parkinson's disease
• d. Wilson's disease 2. Hereditary Dementia,
e.g., Huntington's
• disease
• * 3. Demyelinating disease, e.g., multiple
sclerosis
• * 4. Cerebrovascular disease
• * 5. Chronic Infections
• * 6. Trauma to brain
• * 7. Tumor
• × 8. Metabolic disorders,
• * 9. Drugs & toxins (chronic exposure)

12. Clinical fractures of
dementia
• 1. Multiplecognitivedefects:
• × a. Memory impairment:
• * b. Other cognitive disturbances:Aphasia,
Apraxia,Agnosia
• Disturbance of executive functions
• Disturbed attention,perceptionand orientation
• 2. Associated deterioration ofother functions:
• a. Impaired emotionalcontrol
• b. Depression and anxiety
• c. Impairment of judgment
• d. Psychotic symptoms
• * 3. Associated neurologicalmanifestations:
• a. Usually late
• b. Various sensorv and motor manifestations
• c. incontinenceand bedridden.

13. Management
• Treatment of the cause in
reversible
• types treatment for
irreversible types. Some
medications (anticholine -
esterase inhibitors) may help
delay memory
• and cognitive decline.
• ≥ Supportive measures
Symptomatic treatment for
• agitation, insomnia, psychotic

14. COMMON TYPES
OF DEMENTIA
• Alzheimer disease (50-60% of
all
• dementias) * Vascular
dementia (15-30% of all
• dementias)

15. ALZHEIMER
DISEASE
• Onset, Course & Prognose
• Onset: may be late (after age 65) or
• early (before 65). Gradual onset,
progressive course and
• death within 2-8 years from onset
• * Clinical Features: gradual memory
impairment followed by
• deterioration of other cognitive
aspects.
• Same symptoms of dementia.

16. PATHOLOGY
OF
ALZHEIMER
DISEASE
Degenerative changes,
predominantly in parietal
and temporal lobes (diffuse
cortical atrophy, amyloid
plaques and
neurofibrillary tangles) *
Decreased acetylcholine
metabolism
and degeneration of
cholinergic
neurons

17. AETIOLOGY OF
ALZHEIMER
DISEASE
• Genetic factors play a major role:
• • Familial in 40% of cases
Significantly more in
monozygotic
• than dizygotic twins
• • Related to Down syndrom

18. VASCULAR
DEMENTIA
• More common in males
• • Onset earlier than Alzheimer's disease
• • Course:
• * Onset maybe acute. *Course usually
"stepwise"
• as it reflects recurrent infarct

19. Etiology
Risk factors include: *
Cardiovascular disease
(hypertension, heart
• disease) * Cerebrovascular disease
(atherosclerosis, embolic or thro
• occlusion, hemorrhage )
• * Management:
• same like dementia

20. Clinical Features
• Focal neurological manifestations
• * * Patchy cognitive impairment
• ** Pathology: * Cerebral infarction
and multiple areas of
• neuronal loss

21. THANK YOU