Organic Brain Syndrome

What is organic brain syndrome?

Neurological disorder which provides the psychiatric symptoms due to imperilment of the brain tissues is called organic brain syndrome. In some literature dementia has been used for synonyms for the organic brain syndrome, but it is a misconception, as organic brain syndrome has different clinical presentation, though the manifestation may same. Organic brain syndrome mainly stands to describe the psychological illness rather than neurological, which has no specific etiology, but associated with definable neurological ailment. ^(1,2,3)

Causes

The variety of underlying cause can provide organic brain syndrome. The list of conditions, which can attribute organic brain syndrome are mentioned in below provided list

Traumatic brain injury

• Brain hemorrhage
• Bleeding between the space of the brain meninges
• Blood coagulate in the space of the brain meninges, which can provide pressure inside the brain tissues.
• Concussion can be represented as vibration in the brain due to movement of the cerebro spinal fluid.

Respiratory system related ailments

• Hypoxia or oxygen content become low
• Hypercapnia is termed as increase carbon dioxide level in the blood.

Circulatory system related aliments

• Multiple cardiac stroke attack
• Cardiac infections including endocarditis and myocarditis
• Decrease level of blood reached in the heart muscles.
• Transient ischemic attack (TIA)

Reduction of functional capacity

• Alzheimer disease: progressive mental degenerative disease, which cause premature senility.
• Dementia: persistent mental process disorder
• Creutzfeldt-Jacob disease: rare fatal degerative disorder cause due to neurological impairment
• Diffuse Lewy Body disease: Abnormal protein deposition in the brain cause progressive mental process impairment
• Huntington disease: degeneration of certain portion of the brain
• Multiple sclerosis: inflammation of the myelin sheaths of the neurons present in the central nervous system.
• Normal pressure hydrocephalus: Increase of CSF in the brain cause increase pressure inside the brain.
• Parkinson disease: Decreased dopamine secretion leads to tremor and other associated symptoms.
• Pick disease: Altered personality and social skill impairment due to sporadic or genetic reason.

Metabolic disorders leads to dementia

• Renal function failure
• Hepatic cirrhosis
• Abnormal thyroid gland secretion, which include both hyperthyroidismor hypothyroidism
• Deficiency of Vitamin B1, B12 and folic acid

Drug interaction and alcohol related conditions

• Withdrawal syndrome of alcohol
• Toxic reaction due to drug or alcohol use
• Chronic alcohol abuse or malnutrition leads to neurological disorder, like Wernicke-Korsakoff syndrome
• Withdrawal syndrome related with sedative-hypnotics and corticosteroids

Infectious ailments

• Infectious disease due to acute or chronic condition
• Sepsis or blood toxicity due to infection
• Infection in the brain like as an encephalitis
• Membrane of the central nervous system become infected or meningitis
• Prion infections, like mad cow disease
• Advanced stage of syphilis
• Complications arise due to malignancy can cause OBS
• Miscelneous brain related disorders

Depression

• Psychosis in which emotional and thought process related impairment
• Neurosis is a mental illness due to stress ^(2,3)

Types

There are two types of organic brain syndrome like acute and chronic organic brain syndrome

Acute Organic Brain syndrome

An abnormal mental condition that commencing unexpectedly, which can continue for a few days to 3- 4 weeks. It is related to the inherent brain disorder with central nervous system dysfunction which may follow physiological changes in the brain, which include organic psychotic disorder, cerebral hypoxic delirium and organic mood syndrome.

Chronic organic brain syndrome

Due to long term neurological disorders lead to a chronic organic brain syndrome it is persist for long periods and lead to permanent mental functioning impairments including vascular dementia.

The acute cerebral disorder is more concerned than the chronic type, as acute condition can convert to Chronic organic brain syndrome. ⁽³⁾

Symptoms

The symptoms are related to

• Intellectual impairments involved progressive memory loss, disorientation about place and time, mood swing, uncontrollable emotion, confusion.
• Emotional Disturbance: severely agitated and irritated, when they unable to cope up the situation due to their deteriorated mental state, like unable to provide answers to known question. The patient often become depressive or hysteric. Anxiety, rigidity, uncontrolled sexual emotion, inflexibility, false allegation or suspicious attitude towards other people.
• Behavioral disturbance includes personal habit deterioration like drinking, eating, sleeping habits, publically urinate, total disappointment or depressive approach in regards of self exposure. ^(2,3)

Diagnosis

Following identifiable diagnostic tests can conduct to detect organic brain disorders:

• Analysis of family history and medical history of patient.
• Physical examination
• Complete neurological diagnostic tests conduction
• Psychological test, including intellectual
• Radio isotope scanning
• Serum label checking for vitamin B12 and folic acid
• EEG
• Brain MRI
• Cerebro spinal fluid testing
• Cortical biopsy test ⁽⁴⁾

Treatment

• Supportive treatment and sympathetic attitude are important to clinically deal the patients having an organic brain syndrome
• Psychological counseling of the patient and family members are also included in the treatment therapy
• Environmental peace or place alteration may provide controlling of emotional stress
• Injury or other diseases should be treated properly, so that physical pain can be controlled as much as possible
• Vitamin B complex and folic acid supplementation also recommended for treating the patients. ^(3,4)

References

1. Apostolova LG, DeKosky ST, Cummings JL. Dementias. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds.Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 66.
2. Knopman DS. Alzheimer’s disease and other dementias. In: Goldman L, Schafer AI, eds.Goldman’s Cecil Medicine. 24th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 409.
3. Prem K Chandrasekaran, Stephen T Jambunathan, Nor Z Zainal; Characteristics of patients with organic brain syndromes : A cross-sectional 2-year follow-up study in Kuala Lumpur, Malaysia; Annals of General Psychiatry20054:9; DOI: 1186/1744-859X-4-9; Retrieve from: http://annals-general-psychiatry.biomedcentral.com/articles/10.1186/1744-859X-4-9
4. Organic Brain disorder; Chapter IV; Retrieve from: http://www.dralzainomara.com/books/1/1-3/7.pdf