Psycho-organic syndrome

Some symptoms and pathologies that lead to organic disorders in the brain, it is common to combine in one term - the psychoorganic syndrome. This syndrome is characterized by a triad of signs: impairment of intellectual capabilities, memory loss, emotional instability (lability). In addition to these characteristic symptoms, others may appear, depending on the area of brain damage.

The syndrome is most often manifested in the elderly, but can manifest itself in young and even in childhood.

[1], [2], [3], [4], [5], [6], [7]

Causes of the psycho-organic syndrome

Among the causes of psycho-organic syndrome, the following conditions should be emphasized:

• cerebrovascular disease;
• CNS disease;
• head trauma;
• disorders of metabolic processes, especially chronic;
• decreased oxygen in the blood (hypoxemia);
• poisoning, including chronic (for example, chronic alcohol intoxication);
• infectious diseases;
• inflammatory and tumor processes of the brain.

The pathogenesis of psycho-organic syndrome, as a mental disorder, usually consists of a number of factors:

• direct exposure to toxic substances and their decomposition products on nerve cells;
• the lack of certain substances in the body, without which the normal course of processes in the nervous system is not possible;
• a breakdown in the metabolism of nitrogen in the body;
• improper work of the antioxidant system;
• decontamination of acetylcholine and monoamines;
• failure in GABA-ergic systems.

Persistent psychoorganic syndrome is observed in people who abuse alcohol over a long period of time. Chronic intoxication and lack of B vitamins lead to malfunctions of the Krebs cycle, impaired glucose uptake, glutamate accumulation in neurons. The listed metabolic changes, in turn, provoke occurrence of problems with a dream, seizures, psychotic disorders.

Over time, neurotransmitter mechanisms are depleted, and sustained cognitive impairment is observed.

[8], [9], [10], [11], [12], [13]

Symptoms of the psycho-organic syndrome

As we described above, the first signs of the psychoorganic syndrome are defined by three characteristic manifestations:

• deterioration of perception of new information, loss of ability to remember;
• deterioration of mental judgment and perception;
• emotional lability, unreasonable mood swings.

Sometimes these symptoms are supplemented by frequent and prolonged depressions, hallucinations, periodic delusional conditions. There may be periods of epileptic seizures and psychosis.

Depending on the stage of psychoorganic syndrome, distinguish between light, moderate and severe lesions of the nervous system. The most severe stage threatens the development of organic dementia, which is characterized, in addition to problems with memory and mood, a prolonged clouding of consciousness by the type of stunning.

The late stages of the disease are considered particularly severe: there is oppression or dysfunction of nerve cells in the cerebral cortex, the flow of cerebrospinal fluid and the flow of blood in certain areas of the brain becomes more difficult.

Psycho-organic syndrome after a stroke

Manifestations of the post-stroke psycho-organic syndrome always appear acutely, immediately after the defeat of the brain. Slow increase in symptoms is excluded.

• Self-criticism declines, the evaluation of others worsens. The sense of tact disappears, interests and communication are limited, thoughts acquire a one-sided character. Speech becomes meager, banal, sometimes abstract.
• Deteriorating is the memorization of current events and facts.
• The mood of the patient is usually reduced, or indifferent. It often changes, sometimes it happens abruptly, suddenly. There is a tearful, sensitive, depressed, followed by euphoria, foolishness, which is accompanied by a certain facial expression.

Psycho-organic syndrome in children

In early childhood, the psycho-organic syndrome manifests itself as such signs:

• excessive excitability of the nervous system;
• rapid regurgitation, vomiting;
• diarrhea, constipation;
• allergic manifestations on products considered hypoallergenic;
• disorder of periodicity of sleep and wakefulness;
• poor appetite;
• excessive sensitivity to sounds, light effects, etc .;
• external anxiety;
• frequent moods, mood swings.

Approximately from the age of 5 in a child with a psychoorganic syndrome, impaired motor activity and emotional sphere begin to predominate. Attention is drawn to the following features:

• affective states for no apparent reason;
• a sharp reaction to any surrounding stimuli;
• keeping distance in communication with others, and even with native people;
• obsessions;
• weakened concentration of attention;
• inadequate motor development.

With age, as a child grows up, the vegetative manifestations of the syndrome are gradually replaced by other symptoms. In particular, there is a marked lack of self-criticism and excessive irritability towards others.

Forms

• The asthenic variant is characterized by pronounced changes in intellectual and memory processes. The first sign is emotional incontinence, which is difficult to overlook. Due to emotional instability, the patient becomes difficult to navigate in situations, he is constantly harassed and anxious. This condition can cause headaches and even orientation disorders.

Patients with asthenic manifestations of psycho-organic syndrome inadequately respond to light flashes, flicker, fluctuations in visual images: all this causes them nausea, pain in the head, a general feeling of mental discomfort. Similar feelings are observed if the patient falls into a stuffy, and especially closed room, with a large number of people. Therefore, patients with asthenic psychoorganic syndrome are often unsociable and prefer a solitary pastime.

• Explosive variant proceeds with obvious decrease of intelligence. The patient hardly manages to carry out any work or conduct any activity, it is difficult for him to switch attention, as a result of which he becomes angry, irritable and withdrawn. Attacks of unjustifiably aggressive behavior are observed, which significantly complicates the finding of a patient in society.
• Moderate psycho-organic syndrome manifests itself in the difficulty of exercising patients mental activity. Nevertheless, even such an inconsistency is defined as the initial stage of dementia. The patient has sharp and unreasonable mood swings, mainly in the euphoric side. However, there may be periods of anger, alternating with excessive sensitivity and tearfulness. Such a course of psycho-organic syndrome is also called euphoric.
• The pronounced psycho-organic syndrome draws attention to the absolute absence of the patient's motivation for motor, mental, speech activity and other activities. The patient, as a rule, is apathetic, avoids communication, it is difficult for him to switch topics of conversation, show interest in anything. In addition, the presence of restless suspiciousness and a growing decrease in mental abilities is not excluded.

[14], [15], [16]

Complications and consequences

As the psycho-organic syndrome progresses, misunderstanding on the part of others grows, and the possibility of normal adaptation in society is lost. Close people also do not always understand and support the patient, sometimes dropping their hands in response to an impartial attitude on his part.

Increasing dementia sometimes leads to the fact that a person loses the opportunity to self-service. Neurological disorders join, up to the development of a coma.

[17], [18], [19], [20], [21], [22]

Diagnostics of the psycho-organic syndrome

The complex of diagnostic measures for psycho-organic syndrome consists of the following types of research:

• Examination of the patient, a survey, assessment of complaints, both from the patient and his environment.
• Analyzes: general analysis of blood and urine, determination of ALT and AST, blood bilirubin.
• Instrumental diagnostics: computed tomography of the brain, radiographic examination of the skull, dopplerography, electroencephalography.

In addition, a consultation of a neuropathologist and therapist is prescribed.

[23], [24], [25], [26]

Differential diagnosis

Differential diagnosis is most often performed with schizophrenia.

[27], [28], [29]

Treatment of the psycho-organic syndrome

Treatment is appointed taking into account a provoking factor: for example, if the cause of psychoorganic disorders is alcohol intoxication, then detoxification therapy is performed, and in case of stroke syndrome, post-stroke rehabilitation of the patient is performed.

Medicines that can be used in the treatment regimen of psycho-organic syndrome:

• nootropic drugs (piracetam, phenotropil, pyrithinol, meclofenoxate, semax, cerebrolysin);
• neurotrophic, correctors of cerebral circulatory disorders (nicergoline, vincamine, xanthinol, vinpocetine);
• cerebroprotectors, neuroprotectors (cortexin, citicoline, glycine, emoxipin, gliatilin);
• vitamins (vitamin E - tocopherol, vitamin C - ascorbic acid, B vitamins, nicotinic acid).

Phenotropil
Dose and method of administration	The average dosage is 150 mg twice a day. Duration of admission - from 14 days to 3 months.
Side effects	Sleep disorders, headaches, allergies, increased blood pressure.
Special instructions	The drug is not suitable for treating children.

Semax
Dose and method of administration	The daily amount of the drug is 800-8000 μg. Appointed strictly individually.
Side effects	Itching and burning of the nasal mucosa.
Special instructions	Do not use to treat children under 7 years.

Winkamine
Dose and method of administration	Standard take 10 to 40 mg three times a day for a month.
Side effects	Lowering blood pressure, allergic manifestations.
Special instructions	The drug can not be used for direct intravenous injections.

Xanthinol
Dose and method of administration	With the psychoorganic syndrome taken inside 150 to 600 mg three times a day after meals.
Side effects	Lowering blood pressure, hyperemia and a feeling of heat in the body, indigestion, dizziness, a sense of weakness.
Special instructions	Do not administer to patients with impaired renal function.

Cortexin
Dose and method of administration	Used in the form of intramuscular injections, 10 mg daily for 10 days.
Side effects	Allergies, redness and swelling at the injection site.
Special instructions	The drug is suitable for the treatment of children. Dosage of Cortexin is determined by a doctor individually.

Glycine
Dose and method of administration	Accepted under the tongue until complete resorption, 100 mg to 3 times a day for 2-4 weeks.
Side effects	In rare cases, an allergy is possible.
Special instructions	The drug is especially effective in brain disorders associated with craniocerebral trauma, stroke and alcohol intoxication.

A nicotinic acid
Dose and method of administration	Take 10 mg to 2 times a day, for 2 weeks.
Side effects	Redness of the upper half of the trunk, a sensation of heat, pain in the head, allergic manifestations.
Special instructions	Do not use for hepatitis and cirrhosis.

Physiotherapy

Physiotherapeutic treatment for psycho-organic syndrome allows to cause positive changes in the function of the central nervous system, strengthen immune defense and activate the processes of adaptation of the organism. If there are no contraindications to physiotherapy (tumor processes, hemopoiesis, bleeding, tuberculosis, decompensation of the heart or respiratory function, fever, acute infections), a number of procedures can be used to strengthen the vessels, improve the blood supply to the brain, and also to eliminate some pathological symptoms of the disease.

For patients in an adequate state, electrophoresis with vasodilators, relaxing baths with needles and sea water, magnetotherapy are prescribed.

If the goal of physiotherapy is to lower the tone of the muscles (for example, with convulsions or obsessive movements), then the applications of paraffin or ozocerite, acupuncture, manual therapy can help.

In the presence of pain, diadynamics (pulse currents), ultrasound, thermal stimulation have a good effect.

When the limb function is broken, massage, electrostimulating procedures are used.

In the event that the psychoorganic syndrome is a consequence of acute cerebrovascular accident (stroke), then physiotherapy is prescribed only a month after the acute period.

Treatment with homeopathy

Homeopathy offers the use of complex remedies that have proved themselves in the field of recovery of the body after brain ischemia, toxic effects on the brain and other organic lesions of the nervous system.

With the psycho-organic syndrome, the use of proven homeopathic remedies of the Heel brand is recommended:

• Ubihinon compositum - detoxifying, antioxidant, immunostimulating, anti-inflammatory and metabolic plant remedy in injections. Practice 1 injection 1-2 times a week. The drug has no side effects, only in rare cases there is a painful sensation in the injection zone.
• Coenzyme compositum is a homeopathic remedy, normalizing metabolic processes in tissues, including in the brain tissues. The drug is prescribed for 1 ampoule from 1 to 3 times a week, for 14-60 days. Side effects - allergies.
• Cerebrum compositum is a complex homeopathic remedy for the treatment of diseases of the nervous system of functional and organic etiology. The drug is used in the form of intramuscular injections 1-3 times a week. The duration of therapy is up to one and a half months. Side effects are rare and can be expressed as redness and tenderness at the injection site.
• Vertigoheel is a homeopathic remedy with a psychotonizing, vasodilating and oligodynamic effect. The drug is injected 1 ampoule up to 3 times a week, or in the form of an oral solution of 10 drops 2-3 times a day, half an hour before meals. Side effects were not observed.
• Nervochel is a homeopathic preparation of combined plant and animal composition. Has antidepressant, soothing and anticonvulsant effects on the body. Take under the tongue of 1 tablet three times a day. Very rarely there may be an allergy to the drug.

With the help of homeopathy, it is often possible to cope with two important factors that occur in a psychoorganic syndrome-ischemia and hypoxia. As a result, it is possible to achieve a period of remission and improve the quality of life of the patient.

Alternative treatment

Alternative treatment does not replace conventional drug therapy, but effectively complements it. Of course, herbal treatment is a long process, but sometimes the patience and regularity of accepting herbal remedies truly works wonders.

• It is recommended to drink fresh juice of carrots daily, or to eat carrots. This helps to strengthen the vascular walls, prevents spasms, which serves as a good prevention of ischemia.
• Infusion of peppermint, in combination with chamomile and valerian, will help to normalize the nervous system, eliminate irritability and depression. Usually brewed 1 tbsp. L. Collecting herbs 0.5 liters of boiling water. Take 200-250 ml to 4 times a day.
• It will help restore blood supply to brain structures and infusion of hawthorn fruit. To prepare the medicine, 200 g of dried fruit is poured into ½ liter of boiling water (preferably in a thermos bottle). Infusion is taken throughout the day in large sips.
• A good and simple recipe for improving blood circulation in the brain is tea based on berries of sea bass and sea-buckthorn. The proportions are arbitrary, as the ingredients are added "to taste." In addition, you can add honey or berry jam.

Herbal treatment is efficiently carried out using herbal mixtures, the components of which mutually reinforce the therapeutic effect:

• Brewed 3 tbsp. L. An equivalent mixture of thyme, mint and motherwort in 0.5 liters of boiling water. After a few hours, the infusion is filtered, drinking 100-150 ml twice a day after breakfast and dinner.
• Brew a mixture of dry birch leaves and herbs of wood chistets, insist 3 hours. Take 1 tbsp. L. Twice a day after meals. Duration of admission is 2 weeks.
• Prepare an equal collection of herbs of melissa, oregano, wild carrot seeds, lily of the valley grass and hawthorn. Brewed 2 tbsp. L. Mixture of 0.5 liters of boiling water, left under a lid for 4 hours, filtered and drunk throughout the day.

With mood swings, a collection of dried hawthorn and melissa herbs helps. The ingredients are brewed in a thermos for the night and drunk at least 5 times a day.

[30], [31], [32], [33]

Prevention

Prophylaxis of the progression of psycho-organic syndrome is carried out at the first signs of pathology. Supposed supportive therapy courses, which the patient is given several times a year, both in the hospital and at home. Particular attention is paid to the use of nootropic drugs and vitamin therapy.

[34], [35], [36], [37]

Forecast

The prognosis of the disease depends on its underlying cause. In the overwhelming majority of cases, the patient loses contact with the society, loses the ability to self-service and becomes completely dependent on their loved ones.

Medical expertise often establishes a permanent loss of ability to work, the inability to engage in both physical and intellectual activities.

Unfortunately, there is no data on the cure of patients who have had a psychoorganic syndrome. However, science and pharmaceutics are constantly looking for new ways and methods of fighting diseases, so it remains to be hoped that soon a medicine for specific treatment of the disease will be found.

[38]