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Cognitive and Mental Disorders due to General Medical Conditions (DGMC) Overview

Learn about delirium, dementia, and amnestic disorders, their symptoms, etiology, and treatment. Discover the major neurotransmitters, neuroanatomical areas, and EEG findings, as well as the psychiatric and neurological changes associated with these conditions.

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Cognitive and Mental Disorders due to General Medical Conditions (DGMC) Overview

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  1. COGNITIVE AND MENTAL DISORDERS DUE TO A GENERAL MEDICAL CONDITION (DGMC ) Yard. Doç.Dr. N. Berfu AKBAŞ

  2. “Clinically significant deficit in cognition and memory that represents a significant change from a previous level of functioning” • DELIRIUM • DEMENTIA • AMNESTIC DISORDER • COGNITIVE DISORDERS DGMC

  3. DELIRIUM Disturbance of consciousness and a change in cognition with sudden onset. Abnormalities of mood, perception, behaviour, tremor, nystagmus, incoordination, urinary incontinance Fluctuates during day, worse at night “It’s a syndrome, not a disease!” Other names: acute confusional state, acute brain syndrome, metabolic encephalopathy, toxic psychosis, acute brain failure

  4. Important to recognize; • %90 postcardiotomy • %40-50 after hip fracture surgery • %30 AIDS • %20 after severe burns • %15-20 in general medical wards • Advanced age ( >65-%30-40) • 1 year mortality %50 ( poor prognostic sign)

  5. Etiology: • CNS disease ( epilepsy, brain trauma, infections, neoplasms, vascular disorders) • Systemic Diseases ( arrhytmias, hypoglycemia, hypoxia, hepatic-uremic encephalopathies, endocrine dysfunction, fever, sepsis) • Post-operative states • Drugs and poisons • Electrolyte imbalance of any cause

  6. Major neurotransmitter: Acetylcholine • Neuroanatomical area: Reticular Formation ( attention and arousal ) • EEG: diffuse slowing of background activity • TX: treat the underlying cause!! • Psychotic features: haloperidol • Insomnia: benzodiazepines( lorazepam)

  7. DEMENTIA • Multiple cognitive defects ( impairment in memory, general intelligence,learning, language,problem solving, orientation, perception, attention, judgement ) without impairment in consciousness. • >65, %5 have severe, %15 mild dementia. • Time of death after onset of symptoms: 5-9 years • %60- Alzheimer type, after that vascular dementia most common

  8. Psychiatric and Neurological Changes • Personality • Hallucinations and delusions • Mood • Cognitive changes( aphasia, apraxia, agnosia, seizures, primitive reflexes

  9. AMNESTIC DISORDERS • Retrograde Amnesia: inability to recall previously learned information • Anterograde Amnesia: impairment in the ability to learn new information • Usually short-term, recent memory impaired • İmmediate and remote memory intact. • The specific cause determines the course and prognosis

  10. Thiamine Deficiency ( Korsakoff’s Syndrome) • Hypoglycemia • Seizures • Head trauma • Cerebral Tumors • SVA • Herpes Simplex Encephalitis • Hypoxia • ECT • Multiple Sclerosis • Alcohol • Benzodiazepins

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