Organic syndromes acute delirium Subacute amnestic disordere chronic

Organic syndromes *acute; delirium *Subacute amnestic disordere *chronic; dementia *specific domains *specific medical disorders

Delirium Definition Statistics; 20% medical inpatients elderly, children C/F Acute, attention, disorientation, illusions and hallucinations, Course Fluctuations, worse at night

Delirium Causes 1 -drugs 2 -postoperative 3 -infections 4 -CNS; CVA, TIA, tumors, hematomas, epilepsy, trauma metabolic

Delirium Management cause nursing fluids medications , haloparidol

Dementia Definition: Statistics 5% 65 -70 y 20% 80+y

Dementia C/F long history memory impairment apraxias and agnosias judgment and reasoning delusions and hallucinations disorientation emotional changes personality change

Dementia Classification degenerative, Alzheimer`s, Lewi body disease, picks disease, Huntington`s, Parkinsonism vascular infection; HIV, syphilis, Creutzfeldt-Jacob demylinating illness endocrine; hypothyroidism

Dementia Another classification presenile < 65 ys; Alzheimer’s, CFJ, Huntington`s, Pick’s post senile

Dementia Statistics 50 % Alzheimer’s 20 %Multi infarct 20 % Lewi body

Dementia Alzheimer’s Plaques and tangles basal nuclei Mynert`s(acetylcholine) Lewi Body Type: Lewi bodies, hallucinations, Parkinsonism Multi infarct: stepwise course Picks: frontal lobe CFJ: Prion bodies

Dementia Reversible dementias 1 - subdural haematoma normal pressure hydrocephalus hypothyroidism syphilis pellagra Vit. B 12

Dementia DDx Depressive pseudo dementia Hysterical pseudo dementia

Dementia Management Reality orientation Reminiscence training General Drugs: tetraaminohydrotacrinic acid, anticholine estrases