GAKKEBUSHA-GEYERA-GEYMANOVICHA SYNDROME (V. M. Gakkebush, 1881 — 1931; T. A. Geyer, 1875 — 1955; A. I. Geymanovich, 1882 — 1958 — domestic psychoneurologists; synonym: altsgeymerovsky syndrome, psevdoaltsgeymerovsky disease, asemichesky psychosis of an old age, Gakkebusha — Geyera — Geymanovich a disease) — the symptom complex of the mental disorders arising at presenile and senile age and which are shown weak-mindedness in combination with focal disorders of the highest cortical functions in the form of aphasia, apraxia, agnosia, etc. to-rykh is the cornerstone combined atrophic - vascular or vascular process with preferential localization in the left temporal and parietal areas.
The concept «altsgeymerovsky syndrome» was entered by domestic authors (V. M. Gakkebush and T. A. Geyer, 1912; V. M. Gakkebush and A. I. Geymanovich, 1915), to-rye in the researches devoted clinical and patomorfol. to features of Alzheimer's disease (see. Alzheimer disease ), described the syndrome, similar to displays of this disease, arising at patients with senile dementia at a complication of primary atrophic processes with atherosclerosis of small vessels of a brain. The last are surprised most intensively in the same areas, to-rye suffer from an atrophy at Alzheimer's disease (development of process in «the blazed ways»). The clinic of this form of senile dementia which received according to A. V. Snezhnevsky's proposal, the name «Gakkebusha — Geyera — Geymanovich a Syndrome», was in detail studied further by A. V. Snezhnevsky (1949) and S. G. Zhislin (1960). In 1960 J. Ajuriaguerra's work with sotr was published., in a cut emergence during this disease of separate symptoms of an altsgeymerovsky disease was described.
The clinical picture
Clinical similarity between G. — G. — G. the page developing at senile dementia and Alzheimer's disease consists in development of total weak-mindedness and along with it aphotic disintegration of the speech, the phenomena of agraphia, an alexia, an acalculia, apraxia and optical agnosia. The called focal frustration, unlike Alzheimer's disease, develop in combination with euphoria, confabulations and unruly fussiness of patients. At G. — G. — G. the page is absent the sequence of development of focal symptomatology, characteristic of Alzheimer's disease, the course of a disease quite often more acute and less uniform, often there are acute disorders of cerebral circulation causing an ekzatserbation (strengthening, usually considerable and sharp) symptoms and acceleration of a current. The similar ekzatserbation quite often is followed by passing delirious or amental frustration.
E. V. Averbukh and sotr., V. M. Banshchikov, Yu. E. Rakhalsky, E. Ya. Shternberg, E. Grunthal described other form G. — G. — G. of page of exclusively vascular genesis developing after strokes or gradually. At similarity of a clinical current of this form G. — G. — G. of page with the main displays of Alzheimer's disease the described distinctions during a disease (more acute beginning, an uneven progrediyentnost, insultoobrazny deterioration), separate acute psychotic episodes at the beginning of a disease, as a rule, are found.
The pathological anatomy
Pathomorphologically at the first form G. — G. — G. of page in various departments of a brain is found primary and atrophic process in nervous cells and atherosclerosis of small vessels of a brain. At the second form G. — G. — G. of page changes of vessels and the multiple centers of a softening and desolation with a secondary atrophy of nervous cells come to light, preferential dominant hemisphere is surprised (at the lefthander right). Senile plaques and altsgeymerovsky change of neurofibrilla are a little expressed or are absent.
the Diagnosis is made on the basis of clinical symptomatology and patomorfol. data. In some cases the differential diagnosis of Alzheimer's disease with G. — G. — G. of page is difficult.
At G. — G. — G. pages of vascular genesis give noticeable effect antisclerous therapy (see. Atherosclerosis ) and anticoagulants. The constant training of affected mental functions (a dysmnesia, Gnostic or speech disturbances) allows to detain their disintegration.
Forecast adverse. Patients perish from disturbances of cerebral circulation or intercurrent diseases.
Bibliography: Gakkebush V. M. and Geyer T. A. About Alzheimer’oBCKofi of a disease, Sovr, psikhiat., No. 4, page 253, 1912, bibliogr.; Gakkebush V. M. and Geymanovich A. I. O to the asemichesky system of psychoses of an old age with the atrophic centers in a brain, Clinic and pathological anatomy of Alzheimer'OB-skaya of a disease, Kharkiv, 1915; And with l and S. G's N. About differential diagnosis of psychoses of late age, Zhurn, a neuropath. and psikhiat., t. 60, No. 6, page 707, 1960; Gardens O. To a question of differential diagnosis between Alzheimer's disease and vascular damage of a brain with the Altsgeymerovsky syndrome, in book: Weak-mindedness in old age, under the editorship of E. S. Averbukh, page 52, L., 1968; The Snezh-Nevsky A. V. O senile dementia (To a problem weak-mindedness and psychosis), Zhurn, a neuropath, and psikhiat., t. 18, century 3, page 16, 1949; Shternberg E. Ya. Clinic of dementias of presenile age, page 10, L., 1967; A j u of i a g u-erra J., Muller M. et T i s-s o t R. A propos de quelques problfcmes pos^s par 1’apraxie dans les demences, Encephale, t. 49, p. 375, 1960.
E. S. Averbukh.