What Is Acute Chest Syndrome?

Acute encephalopathy syndrome is also called delirium. It is manifested as disturbance of consciousness, behavioral disorder, lack of purpose, lack of concentration, usually onset of illness, and the condition fluctuates significantly day and night. The syndrome is common in elderly patients. The patient's cognitive function decreased, her arousal level changed, her perception was abnormal, and her day and night were reversed. Acute encephalopathy syndrome is not a disease, but a clinical syndrome caused by a variety of reasons. Its treatment mainly includes etiology treatment, supportive treatment and symptomatic treatment.

Basic Information

nickname

delirium

Visiting department

Neurology

Multiple groups

Seniors

Common causes

Aging, infection, cognitive impairment, poor physical condition (eg heart failure, cancer, cerebrovascular disease), audiovisual impairment, malnutrition, drug / alcohol dependence

Common symptoms

Disturbance of consciousness, disorder of behavior, lack of purpose, lack of concentration

Causes and common diseases of acute encephalopathy syndrome

The occurrence of acute encephalopathy syndrome is often caused by the combined action of susceptible factors and triggering factors, and it is often preceded by certain susceptible factors, such as aging, infection, cognitive impairment (such as dementia), and poor physical conditions (such as heart failure, Cancer, cerebrovascular disease), hearing and hearing disorders, malnutrition, water and electrolyte imbalances, drug / alcohol dependence, etc .; in the presence of one or more susceptible factors, brain function is weakened, which seriously affects the brain's internal environment and causes the brain Endogenous neurotransmitters, neuroendocrine, and acute changes in the nervous immune system can all be contributing factors. Sometimes changes in the environment can trigger delirium, such as changing homes or caregivers, which is especially important for elderly patients.

Differential diagnosis of acute encephalopathy syndrome

EEG in patients with acute encephalopathy syndrome shows slow diffuse brain wave activity, which can be distinguished from depression or other mental illness. Scale examinations are also helpful for its diagnosis. For example, the visual attention scale and picture recognition memory scale can help distinguish acute encephalopathy syndrome from dementia, mental disorders, and focal neurological dysfunction syndrome.

Acute encephalopathy syndrome often has an acute or subacute course. Patients have unconsciousness, inattention, and are prone to delusions, irritability, and agitation. They are often accompanied by fever and sweat. Such symptoms are rare in patients with dementia. But be aware that dementia can be combined with delirium.

Schizophrenia patients have clear consciousness, complete orientation, and hallucinations and delusions have a certain direction, which is different from delirium. Withdrawal from alcoholism can lead to delirium. A long history of alcohol abuse and sudden withdrawal are key to diagnosis.

Examination of Acute Encephalopathy Syndrome

1. Laboratory tests include whole blood routine, blood glucose, liver function, renal function, blood ammonia, blood gas analysis, urine analysis, and urine drug screening.

2. A series of EEGS follow-up observations showed that delirium was accompanied by structural destruction of brain wave rhythms and generally slowed down. The degree to which the rhythm slows is related to the degree of delirium.

3. The delirium caused by intracranial lesions can be seen in other EEG changes, including focal slow wave, asymmetric delta activity and paroxysmal distribution (spike wave, spike wave, spine-slow wave synthesis). Periodic comprehensive waves, such as three-phase waves and periodic epilepsy-like distribution, are helpful for the diagnosis of delirium caused by focal brain injury such as liver failure and cerebral hemorrhage.

4. Other auxiliary examinations, including chest radiograph, electrocardiogram, CT, MRI, etc.

Acute encephalopathy treatment principles

The treatment of acute encephalopathy syndrome mainly includes etiology treatment, supportive treatment and symptomatic treatment.

Cause treatment

It refers to the treatment of primary brain organic diseases or physical diseases, which is the most important treatment link. However, because the etiology is often difficult to identify or difficult to resolve, the etiology treatment becomes difficult.

2. Supportive treatment

Generally includes maintaining water and electrolyte balance and proper nutrition. Appropriate environmental control is recommended throughout the patient's mental state change. The room should be quiet and the light should be soft. Patients should be given strong day or night clues. During the day, keep the lights on and try to keep patients away from noisy places; at night, the lights should be dim.

3. Symptomatic treatment

It refers to giving psychotropic medication to patients' mental symptoms. To prevent the drug from deepening the disturbance of consciousness, small doses of short-term treatment should be given as far as possible. Antipsychotic drugs such as haloperidol, because of their side effects such as lethargy and low blood pressure, can be considered first. Other new antipsychotic drugs, such as risperidone, olanzapine, and quetiapine can also be considered. However, all sedatives, including benzodiazepines, should be used with caution. Because these drugs can increase the disturbance of consciousness, and even inhibit breathing, increase cognitive impairment. Full communication should be made with the patient's family about the principles and risks of medication.