Confabulosis

In modern psychiatry, a kind of psychiatric disorder is distinguished, such as confabulosis, which refers to paramnesia or paramnesic syndromes (impairments or deceptions of memory) that can develop with acute and prolonged symptomatic psychoses.

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Causes of the concubulosis

To date, the pathogenesis of the psychotic state, defined as confabulosis, has not been fully understood, that is, it is not yet known exactly what pathological processes occur in structures of the brain that give false memories. This may be damage to the hippocampus, and pathology of blood circulation in the posterior cerebral arteries, supplying blood to the middle occipital lobes, the lower parts of the temporal lobes of the brain, its trunk and cerebellum.

The emergence of confabulation and confabulosis is associated with a number of somatic diseases and pathologies, which are characterized by the manifestation of symptoms in the form of various psychoses of exogenous etiology.

Listing the most likely causes of concabulosis, psychiatrists call:

• common infectious diseases, including anthroponotic rickettsiosis (typhus), and a number of zoonotic vector-borne infections (eg, malaria);
• primary and secondary encephalitis of various etiologies;
• craniocerebral trauma;
• stay in a coma;
• intoxication (when a psychotic condition occurs due to exposure to the brain of various toxic substances or the abuse of psychotropic drugs);
• disorders of the craniocerebral circulation after a stroke and hemorrhage in the brain (hemorrhagic stroke) and chronic vascular insufficiency of the brain;
• pathology of the endocrine nature (prolonged hypoglycemia, hypothyroidism);
• neuroreusmatism (accompanied by pathological changes in blood vessels and brain envelopes);
• brain tumors (especially localized in the subcortex);
• deficiency of vitamin B1 (causing the Gaye-Wernick syndrome ).

In addition, confabulation and confabulosis - the replacement of real events that have fallen out of memory with bright fabrications and fantasies - are inherent in: progressive amnestic dementia; Korsakov's syndrome with retrograde, anterograde and transient amnesia; paralytic dementia; chronic alcoholism (at which expansive confabulation can be observed); paraphrenic delusional syndrome (which is characteristic of schizophrenia, progressive paralysis, encephalopathic and alcoholic psychoses).

Symptoms of the concubulosis

The main symptoms of concabulosis are expressed in the fact that a person, remembering long-past events and facts, describes his actions and events of the present time in an embellished form and composes something that really was not. In particular, the most incredible "scenarios" are invented, in which the narrator commits selfless actions and shows heroism (saves someone from death, warns of an accident, etc.), makes discoveries, communicates with celebrities, etc. At the same time, the stories are very detailed and full of details, and the narrative style is quite calm.

You can see the first signs of this symptomatic psychosis, when the patient is asked about the recent facts from his life, the answers to which take the form of explicit confabulation - the description of fictitious events.

As the specialists note, the mood of patients is upbeat at the same time, and in the presence of delusions - close to euphoria (which is the difference between a temporary symptomatic confabulosis from progressive confabulation in schizophrenia or amnestic dementia).

In the case of acute symptomatic psychosis, confabulosis manifests itself unexpectedly and after some time spontaneously passes. When a patient leaves this state, he remembers him and can even take the content of his story critically. That is, a person's mental abilities do not suffer. But when the psychotic state passes, the patients most often experience a feeling of fatigue and general weakness, a decrease in vascular tone, heaviness and pain in the head, hyperhidrosis (increased sweating), sleep disorders and other manifestations of asthenia.

If the confabulation and confabulosis progress and are accompanied by disorientation in time and confusion of consciousness, this may indicate vascular (atherosclerotic) dementia, which develops against the background of severe sclerosis of the cerebral arteries and leads to transient ischemic attacks in separate structures of the brain.

There may be complications such as a general memory impairment, a decrease in cognitive abilities and intellectual capabilities with the inevitable attachment of neurological symptoms.

With vascular lesions of the brain, the progression of confabulation has consequences in the form of persistent shifts in personality traits - to the development of irreversible mental disorders.

Diagnostics of the concubulosis

The detection of any symptomatic psychosis, including the diagnosis of confabulosis, is carried out by psychiatrists and neurologists and is based on clinical manifestations of pathology.

Special testing of patients is carried out. And to detect the etiology of confabulation (with the exception of such obvious causes as craniocerebral trauma), blood tests are needed: biochemical, sugar level, thyroid hormones, TDP, oncology markers, etc. According to the results of the tests, infectious diseases , endocrinologists, oncologists.

Instrumental diagnostics include: EEG (electroencephalography), REG (rheoencephalography), Doppler study (UZDG) of cerebral vessels, CT (computed tomography) and MRI (magnetic resonance imaging) of the brain.

Differential diagnosis

The purpose of the correct treatment of confabulation and confabulosis is differential diagnosis, during which it is necessary to distinguish between concabulosis as a manifestation of symptomatic psychosis from schizophrenia, delusional psychoses, paranoid and manic-depressive states, senile dementia and other pathologies.

Treatment of the concubulosis

In all the manuals on psychiatry, it is noted that the treatment of concabulosis is carried out only taking into account its etiology. That is, treat, first of all, the disease that triggered the disorder (a description of methods for treating encephalitis, craniocerebral trauma or hypothyroidism is beyond the scope of this publication).

And as for the symptomatic therapy prescribed by neurologists and psychiatrists, the treatment of concabulosis has no single scheme and focuses on the clinical picture in each individual patient.

Prescribed medications may include antipsychotic drugs - antipsychotics or anxiolytics - depending on the reactive state of the patient's nervous system, and they are taken under conditions of constant monitoring of the central nervous system.

To improve cerebral circulation and metabolism in nerve cells, Piracetam (Pyramem, Nootropilum, Cerebropan, Gabacete and other trade names) is often recommended, which promotes an increase in the rate of passage of impulses through synapses to neurons of the neocortical zones of the brain. Capsules (0.4 g each) or tablets (0.2 g each) should be taken inside at a daily dosage of 0.4-0.8 g (2-3 times before meals) for 1.5-2 months. If patients have kidney problems, the treating physician should monitor the level of creatinine in the blood. Among the contraindications for this medication, in addition to renal failure, cerebral hemorrhage and a child of up to 12 months are indicated. Pyracetam can give such side effects as hyperkinesis, weight gain, skin allergic reactions, headache, sleep disturbance, anxiety.

The drug Ceraxon (Citicoline, Neupileth, Somazina) in the form of a 10% solution for oral administration removes swelling of the brain tissues, which improves their trophic and functioning. This drug adults should take 2 ml three times a day; children - 1 ml each. The course of treatment is 40-45 days. As a result of taking Ceraxon, blood pressure may drop, so hypotonic patients are not prescribed.

In the treatment of confabulation and confabulosis, the drug Piriditol (Piritinol, Encephabol, Bonifen, Neuroxin) is found which activates the metabolism in the brain tissues and protects them from hypoxia. Standard dosage - one tablet (0.1 g) three times a day (after meals); the maximum daily dose is 0.6 g. Duration of administration and specific doses are determined by the physician individually. Side effects include nausea, headache and insomnia; contraindication is the presence in the anamnesis of epilepsy, as well as psychomotor agitation and a tendency to convulsions.

Tanakan, which has no contraindications, contains a powerful angioprotector - an extract of the ginkgo biloba plant, one tablet (40 mg) is used three times a day. Possible side effects are headache and gastric disorders.

With symptomatic psychosis, doctors are also recommended to take vitamins A, C, E and group B. A physiotherapy treatment for confabulation can be performed using hydrotherapy (iodine-bromine baths) and aeroionotherapy (breathing sessions with ionized air).

Forecast

The prognosis of symptomatic psychoses also depends on their cause. If infectious diseases and cerebral vascular insufficiency are cured, concubulosis also passes. However, often somatic diseases become chronic or take a subacute shape, which is accompanied by protracted psychosyndromes of an organic nature.