What are organic diseases? Organic brain damage: what kind of disease is it, can it be treated?

Diseases in this section have a diverse nature and different mechanisms of development. They are characterized by many variants of psychopathic or neurotic disorders. The wide range of clinical manifestations is explained by the different size of the lesion, the area of ​​the defect, as well as the basic individual personality qualities of a person. The greater the depth of the destruction, the clearer the clinical manifestations.

The causes of organic brain damage include:
1. Peri- and intranatal pathology (brain damage during pregnancy and childbirth).
2. Traumatic brain injuries.
3. Infectious diseases (meningitis, encephalitis, arachnoiditis, abscess).
4. Intoxication (alcohol, drugs and other toxic substances).
5. Encephalopathies due to metabolic disorders (diseases of the liver, kidneys, pancreas, etc.).
6. Vascular diseases of the brain (ischemic and hemorrhagic strokes, encephalopathy).
7. Tumors.
8. Demyelinating diseases (multiple sclerosis).
9. Neurodegenerative diseases (Parkinson's disease, Alzheimer's disease).

General cerebral symptoms

Diffuse headaches, aggravated by external stimuli (noise, bright light), movement.
Dizziness, worse with movement, vestibular disorders.
Nausea and vomiting, independent of food intake.
Various autonomic disorders.
Severe asthenic syndrome.

Focal neurological symptoms

Frontal lobe lesion

Unsteady gait (unsteadiness when walking);
paresis and paralysis;
hypertonicity;
paralysis of the head and eye movements;
speech disorders;
focal epileptiform Jacksonian seizures;
grand mal epileptic or tonic-clonic seizures;
unilateral loss of smell (anosmia).

Parietal lobe lesion

Impaired tactile sensitivity;
violation of kinesthesia (sensation of changes in body position in space);
loss of the ability to read, write or count (dyslexia, dysgraphia, dyscalculia);
loss of ability to find a specific place (geographical agnosia);
loss of the ability to identify familiar objects when feeling them with eyes closed (astereognosia - a type of tactile agnosia).

Temporal lobe lesion

Cerebellar lesion

Ataxia - unsteady and clumsy movements of the limbs or torso;
inability to coordinate fine motor skills (tremor, unsatisfactory finger-nose test);
dysdiadochokinesia - the inability to perform rapid alternating movements, for example, quickly bend and straighten fingers; voluntary eye movements are inhibited in extreme positions and lead to saw-tooth movements (nystagmus).

Mental changes

The theory of “exogenous types of reactions” by Karl Bongeffer (1908): the brain responds to external hazards of various etiologies with a limited number of similar non-specific psychopathological reactions.

Psychoorganic syndrome- mental disorders in organic diseases. Presented by a combination of various disorders of three spheres of mental activity (Walter-Bühel triad):
Decrease in intelligence (change in thinking according to the organic type, decrease in the level of judgment, generalizations, concrete thinking, misunderstanding, lack of understanding, impairment of critical abilities);
Weakening of memory (hypomnesia, amnesia, paramnesia);
Emotional disorders (emotional lability, weakness, emotional harshness, dysphoria, euphoria, apathy).

Forms of psychoorganic syndrome are designated by the leading symptom of emotional disorders:
a) Cerebrasthenic - asthenia, accompanied by symptoms of organic pathology of the central nervous system (headaches, weather sensitivity, poor alcohol tolerance, etc.).
b) Explosive - excitability, aggressiveness, mood instability, tendency to dysphoria.
c) Euphoric - superficial unjustified fun, inadequate playfulness, disinhibition, fussiness.
d) Apathetic - inactivity, lethargy, spontaneity, adynamia, indifference to one’s own fate and the fate of loved ones.

Organic mental disorders (organic brain diseases, organic brain lesions) are a group of diseases in which certain mental disorders occur as a result of damage (damage) to the brain.

Causes of occurrence and development

Varieties

As a result of brain damage, various mental disorders gradually (from several months to several years) develop, which, depending on the leading syndrome, are grouped as follows:
- Dementia.
- Hallucinosis.
- Delusional disorders.
- Psychotic affective disorders.
- Non-psychotic affective disorders
- Anxiety disorders.
- Emotionally labile (or asthenic) disorders.
- Mild cognitive impairment.
- Organic personality disorders.

What do all patients with organic mental disorders have in common?

All patients with organic mental disorders have varying degrees of attention impairment, difficulty in memorizing new information, slowed thinking, difficulty in setting and solving new problems, irritability, “getting stuck” on negative emotions, sharpening of features previously characteristic of a given personality, a tendency to aggression (verbal, physical).

What is characteristic of certain types of organic mental disorders?

What to do if you discover the described mental disorders in yourself or your loved ones?

In no case should you ignore these phenomena and, especially, self-medicate! You must independently contact your local psychiatrist at the psychoneurological dispensary at your place of residence (a referral from the clinic is not needed). You will be examined, the diagnosis clarified, and treatment prescribed. Therapy for all the mental disorders described above is carried out on an outpatient basis, by a local psychiatrist or in a day hospital. However, there are cases when a patient needs to be treated in a 24-hour psychiatric hospital:
- with delusional disorders, hallucinosis, psychotic affective disorders, conditions are possible when the patient refuses to eat for morbid reasons, has persistent suicidal tendencies, aggressiveness towards others (as a rule, this happens if the patient violates the maintenance therapy regimen or completely refuses drug treatment);
- for dementia, if the patient, being helpless, was left alone.
But usually, if the patient follows all the recommendations of the doctors at the psychoneurological dispensary, his mental state is so stable that even with a possible deterioration there is no need to stay in a 24-hour hospital, the local psychiatrist gives a referral to a day hospital.
NB! There is no need to be afraid of going to a psychoneurological clinic: firstly, mental disorders greatly reduce a person’s quality of life, and only a psychiatrist has the right to treat them; secondly, nowhere in medicine is human rights legislation observed as much as in psychiatry; only psychiatrists have their own law - the Law of the Russian Federation “On Psychiatric Care and Guarantees of the Rights of Citizens in its Provision.”

General principles of drug treatment of organic mental disorders

1.Striving for maximum restoration of the functioning of damaged brain tissue. This is achieved by prescribing vascular drugs (medicines that dilate small arteries of the brain, and, accordingly, improve its blood supply), drugs that improve metabolic processes in the brain (nootropics, neuroprotectors). Treatment is carried out in courses 2-3 times a year (injections, higher doses of medications), the rest of the time continuous maintenance therapy is provided.
2. Symptomatic treatment, that is, an impact on the leading symptom or syndrome of the disease, is prescribed strictly according to indications by a psychiatrist.

Is there a way to prevent organic mental disorders?

Ekaterina DUBITSKAYA,
Deputy Chief Physician of the Samara Psychoneurological Dispensary
on inpatient care and rehabilitation work,
Candidate of Medical Sciences, psychiatrist of the highest category

The brain is the most complex and most important organ in our body. It is thanks to him that we are superior to all other species. The brain processes all information and all actions that the body performs.

It controls all cells and is responsible for their adaptation to constantly changing environmental conditions. So, from simple tissue - skin, cells evolved into nerve cells. The former have only mechanical properties: protection, permeability. While the nervous ones in their entirety are capable of learning and allow one to remember information and coordinate thoughts.

However, any physical or chemical process must be provided with energy and nutrients. Therefore, proper nutrition, the absence of negative factors and pathological processes are necessary for long and fruitful brain function.

Different types of brain lesions

Since there are a lot of brain disorders, it was advisable to come up with a classification that would cover all diseases:

Organic brain diseases: their types

Organic brain damage (OMD) is characterized by the presence of pathological changes that can be seen using neuroimaging methods.

Any pathological processes are visualized and correlated: benign cysts, amyloid accumulation.

A feature of organic lesions is that there is a substrate in the brain. For example, he also has neurological pathological symptoms, but it is impossible to “see” anything. Organic disorders can be either local or diffuse. Symptoms are also different. With local damage, one type of activity is impaired (intellect). And with generalized symptoms, general cerebral symptoms appear.

Types of organic brain lesions:

Residual organic damage: causes and symptoms

Residual organic damage is the consequences that appear after damage to brain structures in the perinatal period (from 22 weeks of pregnancy to 7 days after birth).

Despite the fact that premature pregnancy is not a mandatory indication for organic brain damage, a weakly developed nervous system is very vulnerable to any unfavorable factors, and since the neuromuscular response has not yet been formed, pathological processes may occur.

The causes of residual organic damage are:

• diseases at the chromosome level;
• insufficient consumption or supply of oxygen to the mother’s body and the associated fetus;
• radiation;
• ecology;
• use of medications or cleaning products;
• poisoning of the expectant mother with alcohol or drugs;
• poor nutrition, expressed in insufficient consumption of micro or macro substances;
• acute or chronic diseases of women;
• pathology of pregnancy.

Any of these factors can lead to slow growth of the baby, which will provoke organic brain damage in children. The clinical picture of this lesion appears immediately after birth, which can be determined not only by a neurologist.

However, it is worth noting that some pathologies can be reversible with the right lifestyle and nutrition. Therefore, it is very important to consult a doctor for help at the initial stages in order to begin treatment as early as possible and in the future forget about any manifestations of organic brain damage.

Clinical picture of acute hypertension

There are practically no specific symptoms that appear with organic brain damage. This is due to the fact that any manifestation depends on the underlying disease, which led to brain damage.

You can identify symptoms that will be characteristic of almost all concomitant pathologies:

• decreased activity;
• apathy, lack of interest in something;
• sloppiness appears.

A rarer symptom, but also common. Patients may forget the names of their relatives or friends, or their appearance. There is a violation of counting and people will not be able to list the numbers from 1 to 10 or remember the sequence of days of the week.

Writing disorders manifest themselves in the rearrangement of syllables and words. In the most severe cases, a person will not be able to speak independently, but will only be able to repeat a small phrase that he hears. Emotionally, there are several possible outcomes.

Or the person becomes kind of unemotional, reacting to everything too calmly, which can’t help but be noticeable. Or, on the contrary, the manifestation of emotions is inadequate and perverted. Hallucinations may occur.

Establishing diagnosis

Diagnosis of organic focal diseases of the brain is important both at the earliest stages and at later stages with already prescribed treatment. Early detection of the disease will allow you to take action and prescribe medications that can stop its progression or even reverse it.

The most important diagnostic stages:

• taking anamnesis;
• neurological examination;

Foci of organic brain damage are shown by arrows

Anamnesis allows you to determine the duration of the disease, its course, and its connection with heredity. A neurological examination is mandatory to identify the causes. Tomography identifies atrophic lesions that cause symptoms.

Providing medical care

A feature of the nervous system is that restoration of neural connections is impossible. You can only increase the activity of the surviving parts of the brain.

The main groups of drugs prescribed for the treatment of organic brain damage:

In addition to drug therapy, the following general strengthening and therapeutic measures are prescribed:

• massage that improves blood circulation to the brain;
• , to improve cerebral circulation and relieve spasms;
• individual or group classes with a speech pathologist and psychologist.

Possible outcomes

All possible consequences and outcomes are divided into three points:

1. Recovery. This is possible if there are no visible defects and the depth of the lesion is small.
2. Disability. The patient is alive, but to a greater or lesser extent loses the ability to work and take care of himself.
3. Disability. Without outside help a person cannot survive.
4. Death.

Any consequences depend on the massiveness of the lesion, the location of the pathological process, age, etiological factor and correctness of treatment.

As you know, the brain is the main organ of the human central nervous system. Scientists have still not been able to fully comprehend all the intricacies of his work. Today, specialists have information about the functioning of individual cells and are quite successful in diagnosing and correcting various diseases of this organ. So a fairly common disorder of this type is considered to be organic brain damage, what it is and what causes it, we will talk on this page www..

It is believed that organic brain damage is a fairly common pathology. Such a diagnosis, according to neurologists, can be made in literally 9 out of 10 patients. However, in most cases, the disturbances are minimal and do not in any way affect the activity of the brain or the person’s well-being.

What is organic brain damage?

Depending on the etiology, organic brain lesions can be diffuse (dyscirculatory encephalopathy, Alzheimer's disease, etc.) or localized (tumors, injuries, stroke, etc.).

Such pathological conditions give different symptoms. Diffuse organic lesions are manifested by memory impairment, decreased intelligence, the patient develops dementia syndrome, cerebroasthenia, psychoorganic syndrome, headache, dizziness, etc. And localized disorders make themselves felt by general cerebral or focal neurological symptoms, depending on the location of the pathological focus, as well as from its volumes.

Why does organic brain damage occur, what are its causes?

Vascular diseases are considered a fairly common factor that provokes organic damage to brain tissue. Among such diseases are hemorrhagic and ischemic stroke, discirculatory encephalopathy, chronic ischemic brain disease. The main root cause of such disorders: hypertension or atherosclerosis. Vascular diseases of the brain mostly cause psychoorganic syndrome, and with a stroke, focal neurological symptoms are also observed.

Organic brain damage can also be caused by traumatic brain injury. The degree of damage depends on the type of injury received (concussion, bruise, compression or traumatic hematoma), as well as on its severity. In this case, patients may be diagnosed with a psychoorganic syndrome (latent or pronounced form), as well as focal manifestations (represented by paralysis, paresis, disturbances of sensitivity, vision or speech, etc.).

Organic brain lesions are often provoked by infections. As is known, a variety of infectious agents can penetrate the blood-brain barrier, including viral and bacterial particles, fungi and some protozoa. Such pathological particles can provoke meningitis, encephalitis, arachnoiditis, and abscesses. Correct and adequate therapy helps to achieve complete recovery, but in some cases the patient remains with cerebroasthenia, mnestic and other mental disorders.

Organic brain damage can be explained by chronic and acute intoxication. Such conditions can develop due to the consumption of alcohol and drugs, smoking and the use of certain medications, due to liver or kidney failure, poisoning with pesticides, mushrooms, household chemicals, carbon monoxide, etc. The manifestations of such disorders are determined by the type of toxic substance, and also its dosage and duration of influence. The patient may even experience intoxication psychoses, deep coma and dementia.

In adulthood, organic brain lesions most often occur due to neurodegenerative diseases. Most often, doctors diagnose Alzheimer's disease, Pick's dementia, or Parkinson's disease. With such pathologies, the patient’s brain neurons are damaged and die, which causes a number of mental disorders.

Therapy of organic brain lesions is carried out only under the supervision of a qualified neurologist.

Organic mental disorders include a group of diseases, the development of which leads to the emergence of certain mental and psychiatric disorders when the brain is damaged.

The causes of the development of organic disorders include:

Types and types of organic mental disorders

As a result of brain damage, various mental disorders gradually develop, which can take from several months to several years, which, depending on the leading syndrome, are grouped as follows:

Dementia;
Hallucinosis;
Delusional disorders.
Psychotic affective disorders;
Non-psychotic affective disorders;
Anxiety disorders;
Emotionally labile, or asthenic, disorders.
Mild cognitive impairment;
Organic personality disorders.

Are there common characteristics of patients with organic mental disorders?

All patients with organic mental disorders have varying degrees of impaired attention, difficulty in remembering new information, slowed thinking, difficulty in setting and solving new problems, irritability, fixation on negative emotions, sharpening of features previously characteristic of a given personality, a tendency to, as verbal as well as physical.

Characteristics of organic mental disorders

Dementia

Dementia syndrome can develop as a result of any of the listed causes of organic mental disorders. With it, attention, memory, thinking, and understanding of the surrounding reality are grossly impaired, the ability to learn almost completely disappears, and basic self-service skills are lost. These phenomena are chronic or progressive. Such a patient is helpless and, as a rule, needs to be deprived of legal capacity and the appointment of a guardian. A diagnosis of dementia is made if the above disorders last for at least six months. Unfortunately, such conditions are almost irreversible; with the help of modern medications it is possible to only slightly slow down the progression of dementia, help the patient become more collected in everyday life, less fussy, anxious, that is, slightly improve the quality of his life. The main emphasis in the treatment of such patients is on quality care, attention and compassion of loved ones.

Mild cognitive impairment

With this disease, attention first of all suffers, which is one of the earliest symptoms, memory decreases, the patient has difficulty acquiring new knowledge, has difficulty setting and solving new problems, and becomes more absent-minded. However, these phenomena are not as profound as in dementia; the patient retains everyday skills, takes care of himself, retains the ability to count, and can independently plan his budget. It is worth noting that dementia never develops suddenly. If you have discovered that you or your loved ones have attention problems, memory loss, or difficulties in learning new knowledge, you need to urgently contact a psychiatrist for a detailed examination, diagnosis and treatment. If you let the situation take its course, mild cognitive impairment will inevitably progress, turn into moderate, then severe, and this process will end in dementia, when it is too late to change anything.

Hallucinosis

Hallucinations are defined as a disturbance of vision when the patient sees, hears, feels various images, sounds, smells, sensations on the skin, inside the body that do not exist in reality. Accordingly, they distinguish between auditory, visual, olfactory, gustatory, and tactile. Hallucinosis is permanent or recurrent, periodically renewed. These patients usually do not have gross impairments of memory, intelligence, disorders of consciousness, or mood; often these patients are critical of their condition, that is, they assess it as a disease and are aware of the need for treatment.

Delusional disorders

Delirium is defined as distorted, absurd, unshakable judgments and conclusions that arise as a result of illness, subordinating the patient’s behavior, and not amenable to criticism and correction. In delusional disorder, the leading syndrome is delusional ideas of various contents: relationships, poisoning, surveillance, damage, jealousy, invention, reform, hypochondriacal, of special origin, special meaning, there may be other types of delusions. Usually accompanied by emotional instability, pathologically elevated or depressed mood, and sometimes hallucinations are interpreted deliriously. These patients, just like with x, do not have gross impairments of memory, intelligence, or disorders of consciousness. However, they usually either do not have criticism of their condition, or it is peculiar, partial. Accordingly, many of these patients do not want to be treated, they are afraid, and they agree to treatment only after lengthy persuasion.

Psychotic affective disorders

Psychotic affective disorders are characterized by pathologically altered mood: depressive (low mood with a feeling of melancholy), manic (high mood). They are accompanied by delusions and/or hallucinations. Usually the patient’s mood corresponds to the content of the delusion: delusional ideas of self-accusation, self-abasement, low value, sinfulness, persecution, relationships, poisoning, surveillance, damage, jealousy, serious illness (hypochondriacal delusions) are colored by a depressive mood; delusional ideas of invention, reformation, and special origin are accompanied by manic experiences.

Hallucinosis, delusional disorders, psychotic depressive disorders are collectively called organic psychoses. These are serious conditions that, if the patient does not comply with the treatment regimen or insufficient treatment is prescribed, can lead (especially in delusional disorder) to aggression towards others, committing crimes, refusing to eat with the development of dystrophy, and committing suicide. Therefore, this group of patients requires special attention from the attending physician and the patient’s relatives.

Non-psychotic affective disorders

Such diseases are called non-psychotic because they are not accompanied by delusions and hallucinations, usually do not require urgent or emergency hospitalization in a psychiatric hospital, and are treated only on an outpatient basis. Depression, or even subdepression, are recognized as conditions that are characterized by persistent, pathologically depressed mood, loss of interests and pleasures, decreased ability to concentrate, low self-esteem, feelings of self-doubt, a gloomy, pessimistic vision of the future, sleep disturbances, low appetite; Unlike psychotic depression, patients do not experience food refusal or suicide. Hypomania, on the contrary, is defined as a state of pathologically elevated mood, accompanied by constant elevation of mood, increased activity, talkativeness, sociability, a sense of physical and mental well-being, increased sexuality, and a decreased need for sleep.

Anxiety disorders

Anxiety disorders are characterized by constant, debilitating, unmotivated anxiety that can range from mild anxiety to a feeling of terror. Usually the patient has no external reasons for anxiety. Anxiety is accompanied by a rapid heart rate, rapid breathing, or shortness of breath, and sometimes increased blood pressure. Such patients are characterized by sleep disturbances, secondary depressed mood, anxiety about their future, and fears of going crazy. The state of anxiety is very painful for patients; usually these people seek help and actively turn to a psychiatrist.

Emotionally labile (asthenic) disorders

Defined as a state of neuropsychic weakness. There are two options. With emotional-hyperesthetic weakness, short-term reactions of dissatisfaction, irritability, anger on minor occasions, tearfulness easily occur, patients are capricious, gloomy, and dissatisfied. There is marked hypersensitivity to sounds, smells, and light. Attention is distracted, the patient has difficulty concentrating. Headaches and insomnia appear. All this reduces performance, a person quickly gets tired, becomes lethargic, passive, and tends to rest often. With the hyposthenic version of asthenic syndrome, lethargy, fatigue, weakness, sluggishness come to the fore; night sleep does not bring a feeling of rest. Asthenic syndrome accompanies absolutely all diseases; it is universal. The only difference is that asthenia, which occurs with any other disease, sooner or later undergoes reverse development and goes away with recovery. The asthenic state in an organic disorder is the leading one; it is usually persistent and hardly reversible.

It's worth remembering

Organic personality disorders

Such diseases develop in cases where the substance of the brain is significantly damaged, and there is no talk of recovery or significant relief of the condition. Changes characteristic of all patients with organic disorders - absent-mindedness, difficulty in remembering new information, slowed thinking, difficulty in setting and solving new problems, irritability, fixation on negative emotions, sharpening of traits previously characteristic of a given personality, a tendency to aggression - become persistent, irreversible, more crudely expressed, a person’s personality changes. Viscosity, thoroughness, slowness both in oral and written speech are added, suspicion, attacks of anger, aggression, euphoria become more frequent, the patient loses the ability to calculate the consequences of his actions, various violations of sexual behavior are possible (decreased, increased sexuality, disturbances of sexual preference ).

Diagnostics

In no case should you ignore the described phenomena and, especially, self-medicate! You need to independently contact a psychiatrist who will prescribe an examination and further treatment. Therapy for all the mental disorders described above is carried out on an outpatient basis, by a psychiatrist or in a day hospital. However, there are cases when a patient needs to be treated in a 24-hour psychiatric hospital:

with ah, ah, psychotic affective disorders, conditions are possible when the patient, for painful reasons, refuses to eat, he has persistent suicidal tendencies, aggressiveness towards others (as a rule, this happens if the patient violates the maintenance therapy regimen or completely refuses drug treatment );
for dementia, if the patient, being helpless, was left alone.

General principles of drug treatment of organic mental disorders

1.Striving for maximum restoration of the functioning of damaged brain tissue. This is achieved by prescribing vascular drugs (medicines that dilate small arteries of the brain, and, accordingly, improve its blood supply), drugs that improve metabolic processes in the brain (nootropics, neuroprotectors). Treatment is carried out in courses two to three times a year (injections, higher doses of medications), the rest of the time continuous maintenance therapy is provided.
2. Symptomatic treatment, that is, an impact on the leading symptom or syndrome of the disease, is prescribed strictly according to indications by a psychiatrist.

Is there a way to prevent organic mental disorders?

Organic mental disorders, as a rule, are secondary; they arise either against the background of an unfavorable general disease, or are a consequence of external brain damage. Some organic mental disorders can be avoided if the causes of their occurrence are prevented.