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Diagnosis > Organic Conditions

Organic Conditions

These can include any physical health/biological reason for the presentation. An non-exhaustive list is as follows:

• A neurological cause: encephalitis, epilepsy, space occupying lesion, other pathology such as multiple sclerosis, dementia

• An endocrinological cause: hyperthyroidism, hypothyroidism, hypoglycaemia, other hormone imbalances

• An infective cause: contributing to a potential delirium

• A metabolic cause: hypercalcaemia

• A iatrogenic cause: medication such as steroids

• A drugs and alcohol cause: effects of long-term drug use, drug intoxication, drug withdrawal (see addictions page)

 

Delirium

 

• Clinical syndrome in response to variety of insults

• Fluctuating global cognitive impairment with behavioural disturbance

• Acute onset

• Clinical symptoms include:

  • Impaired consciousness and attention,

  • Sleep-wake disturbance,

  • Psychomotor disturbance (hyperactive, hypoactive, mixed),

  • Change in emotional reactivity,

  • Confused speech,

  • Perceptual abnormalities (often visual),

  • Fleeting delusions (often paranoid)

 

Dementia

 

• Syndrome of progressive global cognitive impairment

• Usually irreversible

• Clear consciousness

• Effects:  memory, cognition, executive functioning, personality

• Clinical symptoms may include: anxiety, depression, catastrophic reactions, pathological emotion, poorly systematised delusions and hallucinations

• May experience increased confusion towards the end of the day (sundowning)

• May be associated with neurological features

• Exact clinical presentation differs depending on type of dementia

• Wide variety of causes including degenerative disorders, vascular disorders, intracranial lesions, infections, endocrine and metabolic disorders, toxins

• Includes:

  • Alzheimer's dementia - Early memory loss and focal cognitive defects

  • Vascular dementia - May follow a single stroke with acute onset of clinical symptoms or may involve a stepwise deterioration, following several smaller strokes

  • Fronto-temporal dementia - Personality change, language impairment, early loss of insight and other frontal lobe impairments

  • Dementia with Lewy bodies - Parkinsonism, fluctuating cognition and consciousness, hallucinations (often visual), sensitivity to antipsychotics

  • Parkinson disease dementia - Movement disorders with psychomotor slowing, depression is common, mild amnesia, personality change

  • Huntington disease dementia - Chorea, psychiatric symptoms common, family history of Huntington's disease

  • CJD dementia - Rapidly progressing dementia, cerebellar features