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

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

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

Cerebral symptoms

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

Focal neurological symptoms

frontal lobe injury

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).

Damage to the parietal lobe

Violation of tactile sensitivity;
violation of kinesthesia (sensation of a change in the position of the body 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 touching them with closed eyes (astereognosia - a type of tactile agnosia).

Temporal lobe injury

Cerebellar lesion

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

Mental changes

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

Psycho-organic syndrome- mental disorders in organic diseases. It is represented by a combination of various disorders of three areas of mental activity (Walter-Bühel triad):
Decrease in intellect (change in thinking according to the organic type, decrease in the level of judgments, generalizations, concrete thinking, misunderstanding, misunderstanding, violation of critical abilities);
Weakening of memory (hypomnesia, amnesia, paramnesia);
Emotional disorders (emotional lability, weakness, emotional coarsening, dysphoria, euphoria, apathy).

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

Organic mental disorders (organic diseases of the brain, organic brain damage) 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 disturbances, difficulty in remembering new information, slowing down of thinking, difficulty in setting and solving new problems, irritability, "stuck" on negative emotions, sharpening of features previously characteristic of this person, a tendency to aggression (verbal, physical).

What is characteristic of certain varieties of organic mental disorders?

What to do if you find yourself or your loved ones described mental disorders?

In no case should you ignore these phenomena and, moreover, self-medicate! It is necessary to independently contact a district psychiatrist at a neuropsychiatric dispensary at the place of residence (a referral from a polyclinic is not necessary). You will be examined, diagnosed, and treated. Therapy of 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 painful reasons, he has persistent suicidal tendencies, aggressiveness towards others (as a rule, this happens if the patient violates the maintenance therapy regimen or completely refuses medical treatment);
- with dementia, if the patient, being helpless, was left alone.
But usually, if the patient follows all the recommendations of the doctors of the neuropsychiatric dispensary, his mental state is so stable that even with a possible deterioration there is no need to stay in a round-the-clock hospital, the district psychiatrist gives a referral to a day hospital.
NB! There is no need to be afraid of contacting a neuropsychiatric dispensary: ​​firstly, mental disorders greatly reduce the quality of a person’s life, and only a psychiatrist has the right to treat them; secondly, nowhere in medicine is the legislation in the field of human rights so observed 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 medical treatment of organic mental disorders

1. Striving for maximum restoration of the functioning of damaged brain tissue. This is achieved by the appointment of vascular drugs (drugs that expand the 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 drugs), the rest of the time continuous maintenance therapy is carried out.
2. Symptomatic treatment, that is, the effect on the leading symptom or syndrome of the disease, is prescribed strictly according to the indications of a psychiatrist.

Is there a prevention of 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 biological species. The brain processes all the information and all the actions that the body performs.

He controls all cells and is responsible for their adaptation to constantly changing environmental conditions. So, from a 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 you to remember information, 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 is necessary for a long and fruitful work of the brain.

Various types of brain damage

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

Organic diseases of the brain: their varieties

Organic brain injury (OBI) is characterized by the presence of pathological changes that can be seen using neuroimaging techniques.

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

A feature of organic lesions is that there is a substrate in the brain. For example, it also has neurological pathological symptoms, but it is impossible to “see” something. Organic disorders can be both local and diffuse. The symptoms are also different. With a local lesion, one type of activity is disturbed (, intelligence). And with generalized cerebral symptoms appear.

Types of organic brain damage:

Residual organic lesion: causes and symptoms

Residual-organic damage - 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 adverse 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 level of chromosomes;
• insufficient consumption or supply of oxygen to the body of the mother and the fetus associated with this;
• radiation;
• ecology;
• use of medications or cleaning products;
• poisoning of the expectant mother with alcohol or drugs;
• irrational nutrition, expressed in insufficient consumption of micro or macro substances;
• acute or chronic diseases of a woman;
• pathology of pregnancy.

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

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

Clinical picture

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

It is possible to distinguish symptoms that will be characteristic of almost all comorbidities:

• reduced activity;
• apathy, lack of interest in anything;
• sloppiness appears.

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

Violations of writing and are manifested in the rearrangement of syllables and words. In the most severe cases, a person will not be able to speak on his own, but will only be able to repeat a small phrase that he hears. Emotionally, there are several possible outcomes.

Or a person becomes a kind of unemotional, reacting to everything too calmly, which cannot but be evident. Or vice versa, the manifestation of emotions is inadequate and perverted. Perhaps the appearance of hallucinations.

Establishing diagnosis

Diagnosis in organic focal brain diseases 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 measures and prescribe drugs that can stop its progression or even reverse it.

The most important stages of diagnosis:

• collection of anamnesis;
• neurological examination;

Foci of organic brain damage are shown by arrows.

Anamnesis allows you to determine the duration of the disease, its course, the relationship with heredity. A neurological examination is mandatory to identify causes. Tomography identifies atrophic foci, which cause symptoms.

Provision of medical care

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

The main groups of drugs that are 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 the blood supply to the brain;
• , to improve cerebral circulation and relieve spasm;
• individual or group lessons with a defectologist and a 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 the correctness of the treatment.

As you know, the brain is the main organ of the human central nervous system. Scientists have not yet been able to fully comprehend all the subtleties of his work. To date, experts have information about the functioning of individual cells, quite successfully diagnose and correct various diseases of such an organ. So a fairly common disorder of this type is considered to be an organic brain lesion, what it is and what it comes from, 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 literally 9 out of 10 patients. However, in most cases, the violations are minimal and do not affect the activity of the brain and the well-being of a person.

What is organic brain damage?

Depending on the etiology, organic brain lesions may 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 cerebral or focal neurological symptoms, depending on the location of the pathological focus, as well as from its volume.

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

A fairly common factor provoking organic damage to the brain tissue is considered to be vascular ailments. 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 cause mostly a psycho-organic syndrome, and with a stroke, focal neurological symptoms are also observed.

Also, organic brain lesions can be caused by traumatic brain injuries. The degree of damage in this case depends on the type of damage received (concussion, bruise, compression or traumatic hematoma), as well as on its severity. At the same time, patients can be diagnosed with a psychoorganic syndrome (hidden or pronounced form), as well as focal manifestations (represented by paralysis, paresis, impaired sensitivity, vision or speech, etc.).

Organic brain lesions are often provoked by infections. As you know, 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, abscesses. Correct and adequate therapy helps to achieve complete recovery, but in some cases the patient remains cerebroasthenia, mnestic and other mental disorders.

Organic brain damage can be explained by chronic and acute intoxications. Such conditions can develop against the background of alcohol and drug consumption, with tobacco smoking and the use of some drugs, 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 poisonous substance, and also by its dosage 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 neuropathologist.

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 reasons for the development of organic disorders include:

Types and types of organic mental disorders

As a result of brain damage, gradually, which can take from several months to several years, various mental disorders 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.

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, slowing down of thinking, difficulty in setting and solving new problems, irritability, obsession with negative emotions, sharpening of traits previously characteristic of a given personality, a tendency to verbal as well as physical.

Characteristic features 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, understanding of the surrounding reality are grossly violated, the ability to learn almost completely disappears, elementary self-service skills are lost. These phenomena are chronic or progressive. Such a patient is helpless, usually in need of incapacitation and the appointment of a guardian. The 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 drugs it is only possible to somewhat slow down the progression of dementia, help the patient become more collected in everyday life, less fussy, anxious, that is, slightly improve his quality of life. The main emphasis in the treatment of such patients is on quality care, attention and sympathy of loved ones.

Mild cognitive impairment

With this disease, first of all, attention suffers, which is one of the earliest symptoms, memory decreases, the patient has difficulty assimilating new knowledge, with difficulty setting himself and solving new tasks, becoming more distracted. However, these phenomena are not as deep as in dementia, the patient retains household 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 or your loved ones have found impaired attention, memory loss, difficulty in acquiring new knowledge, you need to urgently contact a psychiatrist for a detailed examination, diagnosis and treatment. If you let the situation take its course, then mild cognitive impairment will inevitably progress, turn into moderate, then into severe, and this process will end with dementia, when it will be too late to change anything.

Hallucinosis

Hallucinations are defined as a violation of the idea, when the patient sees, hears, feels various images, sounds, smells, sensations on the skin, inside the body, which are not in reality. Accordingly, there are auditory, visual, olfactory, gustatory, tactile. Hallucinosis is permanent or recurrent, periodically recurring. These patients usually do not have gross violations of memory, intelligence, disorders of consciousness, mood, often these patients are critical of their condition, that is, they evaluate it as a disease and are aware of the need for treatment.

delusional disorders

Delusions are defined as distorted, absurd, unshakable judgments and conclusions arising as a result of an illness, subordinating the patient's behavior, not amenable to criticism and correction. With a delusional disorder, the leading syndrome is delusional ideas of various contents: relationship, poisoning, surveillance, damage, jealousy, invention, reformism, hypochondriacal, special origin, special significance, there may be other varieties of delirium. Usually accompanied by emotional instability, pathologically elevated or depressed mood, sometimes delusional hallucinations are interpreted. In these patients, as well as in x, there are no gross violations of memory, intellect, and disorders of consciousness. However, they usually either have no criticism of their state, or it is peculiar, partial. Accordingly, many of these patients do not want to be treated, they are afraid, 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, relationship, poisoning, surveillance, damage, jealousy, serious illness (hypochondriac delirium) are colored by a depressive mood; delusional ideas of invention, reformism, special origin are accompanied by manic experiences.

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

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 persistently, pathologically low mood, loss of interests and pleasures, decreased ability to concentrate, low self-esteem, a sense of self-doubt, a gloomy, pessimistic vision of the future, sleep disturbances, low appetite; unlike psychotic depression, patients do not have food refusals or suicides. Hypomania, on the contrary, is defined as a state of pathologically elevated mood, accompanied by a constant rise in mood, increased activity, talkativeness, sociability, a sense of physical and mental well-being, increased sexuality, and a decrease in the need for sleep.

Anxiety disorders

Anxiety disorders are characterized by constant, debilitating, unmotivated anxiety that can range from mild anxiety to feelings of terror. Usually there are no external causes for anxiety in the patient. Anxiety is accompanied by a rapid heartbeat, rapid breathing, or shortness of breath, and sometimes an increase in blood pressure. Such patients are characterized by sleep disturbances, secondary low mood, anxiety for their future, and fears of going crazy. The state of anxiety is very painful for patients, usually these people seek help, they themselves 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 discontent, irritability, anger for minor reasons, tearfulness easily occur, patients are capricious, gloomy, dissatisfied. Marked hypersensitivity to sounds, smells, and light is noted. Attention is scattered, it is difficult for the patient to concentrate. There are headaches, insomnia. All this reduces efficiency, a person quickly gets tired, becomes lethargic, passive, tends to rest often. With the hyposthenic variant of asthenic syndrome, lethargy, fatigue, weakness, slowness 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 a reverse development and disappears with recovery. The asthenic condition in 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 has been significantly damaged, and there is no question of recovery or significant relief of the condition. Changes characteristic of all patients with organic disorders - absent-mindedness, difficulty in remembering new information, slowing down of thinking, difficulty in setting and solving new problems, irritability, obsession with negative emotions, sharpening of traits previously characteristic of this person, a tendency to aggression - become persistent, irreversible, more roughly expressed, the personality of a person changes. Viscosity, thoroughness, slowness both in oral and written speech, suspiciousness, 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 (reduced, increased sexuality, violations of sexual preference ).

Diagnostics

In no case should you ignore the described phenomena and, moreover, self-medicate! It is necessary to independently contact a psychiatrist, who will prescribe an examination and further treatment. Therapy of 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 refuses food for painful reasons, 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 );
in dementias, if the patient, being helpless, was left alone.

General principles of medical treatment of organic mental disorders

1. Striving for maximum restoration of the functioning of damaged brain tissue. This is achieved by the appointment of vascular drugs (drugs that expand the 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 drugs), the rest of the time continuous maintenance therapy is carried out.
2. Symptomatic treatment, that is, the effect on the leading symptom or syndrome of the disease, is prescribed strictly according to the indications of a psychiatrist.

Is there a prevention of organic mental disorders?

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