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Diagnosis > Organic Conditions

Organic Conditions

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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