Organic mental illness

Gg mental organik

• Delirium • Akut/subakut• Fluktuasi• ∆ atensi sejak awal• Inkoheren >• Hal visual >• Tremor >• ∆ EEG >

• Demensia• Kronik progresif• Persisten • ∆ Atensi pd std lanjut• Koheren >• Hal visual <• Tremor <• ∆ EEG <

Etiologi delirium• ∆ cardiopulmonal

congestive heart fpneumoniachronic obs pulm disasthma br

• ∆ gastrointestinalhepatic encephalopathpancreatitis

• ∆ urogenitalrenal failureurinary tr infection

• Intoksikasialkoholnarkotikapsikofarmakazat lainnya

• ∆ neurologikmeningitisencephalitislesi temporoparietal lesi occipital

Demensia

• Cortical• Kcptn psikomotor N• ∆Motorik std lanjut• ∆Memori +• ∆Fungsi eksekutif <• Depresi <• Apathy <• ∆Cortex cerebri• Contoh Dx

: Alzheimer >

• Sub cortical• Kcptn psikomotor ↓ • ∆Motorik sejak awal• ∆Memori +• ∆Fungsi eksekutif >• Depresi >• Apathy >• ∆Subcotical• Contoh

Dx :Encephalopathy

Diagnosis ALZHEIMER• Definitif

kriteri klinis probable +PA (autopsi/biopsi)

• Probable onset: 40-90th

conciousness Nprogressive worseningdemensia # ∆sistemik

• Possibledemensia ∆sistemik

• Unlikelysudden onset∆neurologik focaldidahului ∆seizer/∆gait

Patologi anatomi ALZHEIMER

• Temporo-parietal cortex : degenerasi cholinergic neuron

• Neurofibrillary tangle• Amyloid plaque• Radiologik:pelebaran ventrikel III

Diagnosis banding ALZHEIMER

• Demensia vaskular∆cognisi >, ∆ADL∆focal~strokeabruot deterioration

• Depresi• Degenerasi frontal lobe• Hydrocephalus• Infeksi CNS demensia

PENUNJANG DX DEMENSIA

• Lab standart –darah lengkap - urine lengkap

- TSH• Radiologis- MRI - neuroimaging• Sistemik tes – EEG - lain2 ~ indikasi

Terapi farmakologik ALZHEIMER

• AChE INHIBITORTacrine memantineciticolinedonepezil

• Nootropicpiracetam