Late amnesia

Introduction Posterior amnesia: refers to the recovery of consciousness after the occurrence of the disease (such as after traumatic brain injury, after CO poisoning wakes up), the memory is still good, after a period of time, there is obvious forgetting. The causes of intellectual disabilities can be divided into two categories: 1 congenital mental retardation: such as mental retardation, mostly caused by genetic and environmental factors. Environmental factors include infection during pregnancy, birth injury, and hypoxia and infection in the brain after birth. Genetic factors include hereditary metabolic defects, chromosomal abnormalities, and dominant genes. 2 Acquired sexual intelligence disorders: such as acute brain trauma, metabolic disorders, poisoning diseases can cause temporary mental retardation, dementia and the like are the most common acquired progressive cognitive dysfunction.

Cause

(1) Causes of the disease

The causes of intellectual disabilities can be divided into two categories:

1 congenital mental retardation: such as mental retardation;

2 Acquired sexually impaired disorders: such as acute brain trauma, metabolic disorders, poisoning diseases can cause temporary mental retardation, dementia is the most common acquired progressive cognitive dysfunction.

(two) pathogenesis

1. Intelligent dysplasia (oligophrenia) also known as mental retardation. This is a state in which mental development is impeded or incomplete. Mostly caused by genetic and environmental factors. Environmental factors include infection during pregnancy, birth injury, and hypoxia and infection in the brain after birth. Genetic factors include hereditary metabolic defects, chromosomal abnormalities, and dominant genes.

2. Memory impairment memory is a more complicated problem, because the memory process includes information reception, encoding-storage and decoding-retrieval. The structures most likely to participate in the formation of memory traces are the cerebellum, hippocampus, amygdala and cerebral cortex.

an examination

Select the necessary selective tests based on the likely cause.

1. Blood routine, blood biochemistry, and electrolyte attention have specific diagnostic changes for the primary disease.

2. Blood glucose, immune items, and cerebrospinal fluid examinations have abnormal diagnostic significance. Hematological examination is essential for determining dementia with endocrine disease and liver and kidney failure. Hypothyroidism is a reversible cause of dementia. When the serum vitamin B12 level is measured, vitamin B12 deficiency can be found, but there can be no anemia. Neurosyphilis is extremely rare, but it is also a reversible cause. Therefore, serological examination of syphilis must be mandatory. The concentration of the drug in the blood can be detected for poisoning. If clinical presentation suggests evidence of vasculitis or arthritis, erythrocyte sedimentation rate and screening for connective tissue disease (eg, antinuclear antibodies and rheumatoid factor) are required. For any young person with dementia, consideration should be given to the determination of human immunodeficiency virus titer, and if there is a manifestation of dyskinesia, ceruloplasmin should be measured.

The following items are abnormal and have a differential diagnosis.

1. CT, MRI examination.

2. EEG is helpful in identifying Creutzfeldt-Jakob disease, which has the characteristics of periodic discharge.

3. Skull base film, fundus examination.

4. Single-photon emission computed tomography (SPECT) functional brain imaging may also be helpful in diagnosis.

Differential diagnosis

It needs to be distinguished from the following symptoms: Separation and forgetting: On the one hand, it shows serious forgetting, on the other hand, it shows the ability to engage in various complex activities, and take care of itself in an orderly manner. There is a clear contradiction and separation between the forgetting of the patient and the knowledge ability that it shows. Therefore, the name is separated and forgotten.

Complete amnesia: Transient global amnesia syndrome (TGA) is a sudden, transient, near-forgotten clinical syndrome that lasts for 1 to 24 hours. When the attack occurs, the patient cannot remember new things. There are varying degrees of near and far memory loss, but self-knowledge, speaking, writing, and computational power remain good. The clinical features of TGA are generally occurring in the elderly with moderate health or no obvious cardiovascular and cerebrovascular diseases. It is characterized by sudden loss of memory, short-term access to new knowledge, varying degrees of retrograde forgetting, often fidgeting, and repeatedly asking the same questions. Interictal conversation, writing and computing skills remain normal, personality retention, complete self-knowledge, symptoms lasting for several hours, complete recovery within 24 hours (more than 3-6 hours). More women than men.

Anterior amnesia: Anterior amnesia is an amnesia that forgets things that happen after an event that caused amnesia. The disease is different from retrograde amnesia, not before forgetting the amnesia event. To a large extent, because people do not study the exact mechanism of memory very well, scientists can only point out which part of the brain is working, and antegrade amnesia is still a mysterious disease.

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