Cognitive impairment ( memory , language, perception) - Causes, Symptoms and Treatment .MF .
cognitive brain function - the ability to understand, to learn, to study, to recognize, to perceive and process (remember, transmit, use) external information.This is a function of the central nervous system - the higher nervous activity, without which the human person is lost.
Gnosis - the perception of information and its processing, mnemonic function - a memory, praxis and speech - is the transfer of information.By reducing these mnestiko - intellectual functions (including baseline) show cognitive impairment, cognitive deficit.
cognitive decline is possible with neuro-degenerative diseases, cardiovascular diseases, neuroinfections, heavy head - brain injuries.The mechanism of development of mechanisms play a major role, dissociative communication cortex with subcortical structures.
The main risk factor is considered hypertension that triggers the mechanisms of vascular trophic disorders, atherosclerosis.Episodes of acute circulatory disorders (stroke, transient ischemic attack, cerebral crises) c
There violation neurotransmitter systems: the degeneration of dopaminergic neurons with a decrease in the contents of dopamine and its metabolites, reduced activity Noradrenegic neurons, triggered a process of excitotoxicity, ie neuronal death resulting from disorders of neurotransmitter relationships.What matters is the magnitude of the damage and the localization of the pathological process.
So, with the defeat of the left hemisphere may develop apraxia, aphasia, agraphia (inability to write), dyscalculia (the inability to count), Alex (inability to read), alphabetic agnosia (non-recognition of letters), violated the logic and analysis, mathematical ability,inhibited arbitrary mental activity.
defeat of the right hemisphere appears visually - spatial impairments, inability to consider the situation as a whole, the body breaks down the scheme, spatial orientation, emotional coloring of events, the ability to dream, to dream, to compose.
frontal lobes of the brain play an important role in almost all cognitive processes - memory, attention, will, expressive language, abstract thinking, planning.
temporal lobes provide the perception and processing of sounds, smells, visual images, integration of data from all the sensory analyzers, remembering the experience, the emotional perception of the world.
Damage parietal lobes of the brain gives you a variety of options of cognitive impairment - a disorder of spatial orientation, Alex, apraxia (inability to perform purposeful action), agraphia, dyscalculia, disorientation - left - right.
occipital lobe - a visual analyzer.Its function - the field of vision, color perception and face recognition, images, colors, and the relationship of objects with colors.
defeat of the cerebellum causes cerebellar cognitive affective syndrome with blunting of emotional sphere, disinhibited inappropriate behavior, speech disorders - a decrease in fluency, the emergence of grammatical errors.
Priichiny cognitive disorders
Cognitive impairment may be temporary, after a traumatic brain injury, poisoning and recover in time ranging from days to years, and may have a progressive course - Alzheimer's disease, Parkinson's disease.
Vascular diseases of the brain - the most common cause of cognitive disorders of varying severity from minimal to vascular dementia disorders.First place in the development of cognitive impairment takes hypertension, further occlusive atherosclerotic lesions of major vessels, their combination, compounded by acute circulatory disorders - stroke, transient attacks, systemic violations krovoobrascheniya- arrhythmia, vascular malformations, angiopathy, violations of blood rheology.
metabolic disorders in hypothyroidism, diabetes, kidney and liver failure, a lack of vitamin B12, folic acid, alcoholism and drug addiction, abuse antidepressants, antipsychotics, tranquilizers can cause the development of dismetabolic cognitive disorders.With early detection and treatment may be reversible.
Therefore, if you have noticed at some emerging intellectual deviations - see your doctor.It is not always the patient himself can figure out what happened to him that something was wrong.The man gradually loses the ability to think clearly, to remember current events and at the same time clearly remember the long, reduced intelligence, orientation in space, the character changes in the irritable, possible mental disorders, impaired self.Relatives may be the first to draw attention to violations of everyday behavior.In this case - bring the patient to be examined.
survey in violation
cognitive functions to determine the presence of cognitive impairment is taken into account the initial level.Queried and the patient and relatives.Have the values of dementia cases in the family, head trauma, alcohol consumption, episodes of depression, taken drugs.
neurologist at survey can detect the underlying disease with corresponding neurological symptoms.Analysis of mental status tests carried out on various roughly neurologist and psychiatrist in depth.Are investigated care, reproduction, memory, mood, following the instructions, imaginative thinking, writing, arithmetic, reading.
widely used short scale MMSE (Mini-mental State Examination) - 30 questions for a rough estimation of the state of cognitive functions - orientation in time, place, perception, memory, speech, performance of the three-step tasks, reading, copying the.MMSE is used to assess the dynamics of cognitive functions, the adequacy and effectiveness of the therapy.
Easy cognitive decline - 21 - 25 points, heavy 0 - 10 points.30 - 26 points is considered the norm, but it should take into account the initial level of education.
more accurate clinical dementia rating scale (Clinical Dementia Rating scale - CDR) based on research orientation disorders, memory, interactions with others, behavior at home and at work, self-service.On this scale, 0 points - this is the norm, 1 point - mild dementia, 2 points - moderate dementia, 3 - severe dementia.
Scale - Battery frontal dysfunction is used to screen for dementia, mainly affecting the frontal lobes and subcortical cerebral structures.This is a more complex procedure and determined disturbances in thinking, analysis, synthesis, selection, fluency, praxis, attention to reaction.0 points - severe dementia.18 points - the highest cognitive abilities.
hours drawing test - a simple test when the patient is asked to draw a clock - dial with numbers and arrows pointing in a certain time can be used for differential diagnosis of dementia of the frontal type and with the defeat of the subcortical structures of the Alzheimer's.
For the patient with the presence of acquired cognitive deficits necessary to carry out laboratory tests: blood test, lipidogram, determination of thyroid-stimulating hormone, vitamin B12, blood electrolytes, liver function tests, creatinine, nitrogen, urea, blood sugar.
for imaging brain lesions used computer and magnetic resonance imaging, Doppler great vessels, electroencephalography.
electroencephalography method .
patient is examined for the presence of somatic diseases - hypertension, chronic lung disease, heart.
carry out differential diagnosis of vascular dementia and Alzheimer's disease.Alzheimer's disease is characterized by a gradual onset, a slow gradual progression, minimal neurological impairment, memory impairment, and later executive function, cortical type of dementia, lack of gait disorders, atrophy in the hippocampus and temporal - parietal cortex.
sure treatment of the underlying disease!
for the treatment of dementia use of donepezil, galantamine, rivastigmine, memantine (abiksa, meme), nicergoline.Dosages and duration of reception circuits are selected individually.
to improve cognitive functions used drugs of different pharmacological groups with neuroprotective properties - glycine, Cerebrolysin, Semax, somazina, tserakson, nootropil, piracetam, pramistar, memoplant, Sermion, cavinton, mexidol mildronat, solkoseril, cortexin.
sure treatment of hypercholesterolemia.This helps reduce the risk of cognitive dysfunction.This adherence to a diet low in cholesterol - vegetables, fruits, seafood, low-fat dairy products;B vitamins;statins - Lipitor, atorvastatin, simvatin, torvakard.Avoid smoking, alcohol abuse.
Consultation of the neurologist on cognitive impairment
question: Is useful crossword puzzles?
Answer: yes, it is a kind of "gymnastics" for the brain.It is necessary to force the brain to work - to read, recite, memorize, write, draw ...
Question: Can the development of cognitive impairment in multiple sclerosis?
answer is yes, cognitive deficits in multiple sclerosis structure constitute violations of speed of information processing, mnemonic disorders (short-term memory), disorders of attention and thinking, visual - spatial disorders.
Question: What is "induced cognitive potentials"?
Answer: electric reaction of the brain to perform mental (cognitive) tasks.Neurophysiological methods caused by the cognitive potential - it is a record of bioelectric brain reactions in response to the performance of mental tasks using electroencephalography.
Question: which drugs can be taken alone for mild distraction, impaired attention and memory after the emotional overload?
A: glycine 2 tablets dissolve under the tongue or preparations of ginkgo biloba (memoplant, ginkofar) 1 tablet 3 times a day, vitamin B (Neurovitan, milgamma) up to 1 month or nootropil - but then the dosage prescribed by a doctor according tothe age and disease.And it is better to consult a doctor - you may underestimate the problem.
Neurologist Kobzev SV