AMENTAL SYNDROME

From Big Medical Encyclopedia

AMENTAL SYNDROME (Latin amentia — madness) — one of symptom complexes of stupefaction, at Krom prevails confusion, incoherence of thinking, the speech and motive acts. In 19 century the amentia was considered as an independent disease — a special form of acute psychosis [Meynert (T. Meynert), etc.]; in a crust, time only some authors [Pauleykhoff (V. of Pauleikhoff) hold this opinion. On Bongeffera (To. Bonhoeffer, 1912), Ampere-second. treats exogenous types of reactions.

Depending on dominance in a clinical picture of Ampere-second. these or those symptoms Bongeffer and other authors distinguished the following his forms: hallucinatory (so-called hallucinatory confusion); catatonic with dominance of psychomotor frustration and maniformny with the dominance of incoherence (inkogerentnost) and the ideas of greatness similar to those at a general paralysis (see). However these differentiations are substantially conditional.

A clinical picture

In a clinical picture of Ampere-second. incoherence of thinking and the speech prevails, confusion, affect of bewilderment are characteristic; also the symptom of a hypermetamorphosis (the raised otvlekayemost of attention) is observed. In a condition of speech initiation of the statement can consist of separate words, shouts or inarticulate sounds. Patients are disoriented in time, a situation and is frequent in own personality; the attention is fixed hardly, perception and reactions are slowed down. Psychomotor excitement, quite often uniform, limited to limits of a bed is observed.

Sometimes excitement has character of a chaotic throwing (yaktation), the voznikatdiskoordinirovanny movements and horeopodobny twitchings can, and from time to time patients stiffen in a stupor.

Often Ampere-second. develops after a delirious state or at the patient manifestations of amental and delirious syndromes are replaced.

Unlike a delirium, hallucinatory disturbances, generally visual and acoustical, are less expressed and more sketchy. Also rather scanty figurative crazy ideas are incoherent and sketchy, as a rule.

Reminiscence of the period of acute frustration does not remain.

Etiology

Ampere-second. can arise at various acute infectious psychoses (at typhus, sepsis, an ugly face, etc.), and also within somatopsychoses at which the factor of exhaustion plays a role. At bad attacks of endogenous psychoses (schizophrenia, maniac-depressive psychosis) the pictures reminding an amental state can be observed. Amentivnopodobny states can meet also at vascular and atrophic processes of presenile and senile age.

The diagnosis

the Diagnosis is made on the basis of the given the anamnesis and clinical manifestations. The differential diagnosis between Ampere-second. exogenous genesis in the acute period and amentivnopodobny states at schizophrenia and maniac-depressive psychosis it is difficult p demands the careful accounting of the anamnesis of N of a somatic state. It is necessary to investigate the patient during temporary clearing of consciousness: at infectious or intoksikatsionny psychosis of the patient it is available, depressive, at schizophrenia — it is autistic, unavailable.

Forecast

Forecast of Ampere-second. exogenous genesis, unlike conditions of confusion of consciousness at endogenous psychoses, it is not always favorable: transitions to a long asthenic state (T. I. Yudin) and to mental weakness — a chronic psychoorganic syndrome are described (see. Psychoorganic syndromes ).

Treatment

Treatment: at acute Ampere-second., caused by a somatopathy, disintoxication therapy, fight against dehydration and cardiovascular weakness (danger of a collapse) is necessary; in a crust, time with success apply psychotropic (antipsychotic) drugs on the general to them to indications. At endogenous diseases — treatment of the main disease.

Bibliography

Korsakov S. S. Chosen works, page 175, M., 1954; Yudin T. I. An amentia and a neurasthenia, in book: Probl. acute ekzogen. psikhicheek. diseases, under the editorship of T. I. Yudin and M. A. Goldenberg, page 78, Kharkiv, 1935; Bleuler M., Willi J. u. Bühler H. R. Akute psychische Begleiterscheinungen körperlicher Krankheiten, Stuttgart, 1966; Bonhoeffer K. Die Psychosen im Gefolge von akuten Infektionen. Allgemeinerkrankungen und inne-ren Erkrankungen, Handb. Psychiat., hrsg. v. G. Aschaffenburg, Abt. 3, spez. T., Hlft. 1, S. 2, Lpz. — Wien, 1912; Meynert T. Klinische Vorlesungen über Psychiatric auf wissenschaftlichen Grundlagen, S. 33, Wien, 1890; Pauleikhoff B., Müller-Fahlbusch H. u Meissner U. Die Amentia, Fortschr. Neurol. Psychiat., S. 125, 1967.

E. Ya. Shternberg.

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