Diagnosis > Organic Conditions
Organic Conditions
These can include any physical health/biological reason for the presentation. An non-exhaustive list is as follows:
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A neurological cause: encephalitis, epilepsy, space occupying lesion, other pathology such as multiple sclerosis, dementia
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An endocrinological cause: hyperthyroidism, hypothyroidism, hypoglycaemia, other hormone imbalances
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An infective cause: contributing to a potential delirium
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A metabolic cause: hypercalcaemia
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A iatrogenic cause: medication such as steroids
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A drugs and alcohol cause: effects of long-term drug use, drug intoxication, drug withdrawal (see addictions page)
Delirium
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Clinical syndrome in response to variety of insults
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Fluctuating global cognitive impairment with behavioural disturbance
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Acute onset
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Clinical symptoms include:
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Impaired consciousness and attention,
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Sleep-wake disturbance,
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Psychomotor disturbance (hyperactive, hypoactive, mixed),
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Change in emotional reactivity,
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Confused speech,
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Perceptual abnormalities (often visual),
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Fleeting delusions (often paranoid)
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Dementia
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Syndrome of progressive global cognitive impairment
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Usually irreversible
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Clear consciousness
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Effects: memory, cognition, executive functioning, personality
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Clinical symptoms may include: anxiety, depression, catastrophic reactions, pathological emotion, poorly systematised delusions and hallucinations
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May experience increased confusion towards the end of the day (sundowning)
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May be associated with neurological features
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Exact clinical presentation differs depending on type of dementia
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Wide variety of causes including degenerative disorders, vascular disorders, intracranial lesions, infections, endocrine and metabolic disorders, toxins
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Includes:
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Alzheimer's dementia - Early memory loss and focal cognitive defects
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Vascular dementia - May follow a single stroke with acute onset of clinical symptoms or may involve a stepwise deterioration, following several smaller strokes
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Fronto-temporal dementia - Personality change, language impairment, early loss of insight and other frontal lobe impairments
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Dementia with Lewy bodies - Parkinsonism, fluctuating cognition and consciousness, hallucinations (often visual), sensitivity to antipsychotics
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Parkinson disease dementia - Movement disorders with psychomotor slowing, depression is common, mild amnesia, personality change
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Huntington disease dementia - Chorea, psychiatric symptoms common, family history of Huntington's disease
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CJD dementia - Rapidly progressing dementia, cerebellar features
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