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Nutrient deficiency

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction Evidence for nutritional metabolic deficiency disease, such as dystrophic history of niacin vitamin B1 and folic acid deficiency, and lack of nutritional metabolism lead to symptoms and signs of corresponding dysfunction, which can be used as a diagnostic condition for mental disorders associated with nutritional metabolic diseases.

Cause

Cause

Causes of lack of nutritional metabolism

Vitamin B1 deficiency is associated with a variety of neuropsychiatric disorders, and the severe typical neuropsychiatric syndrome it causes is beribi (beriberi) and Wernicke encephalopathy. The pathological changes mainly occur from the hypothalamic midbrain aqueduct in the papillary body to the fourth ventricle and cerebellar cortex, and there are bilateral symmetrical perivascular endothelial cell hypertrophic sporadic hemorrhage, and mental retardation occurs; if the network structure is involved, consciousness disorder occurs. Brain edema can occur when vitamin B1 deficiency is associated with glucose metabolism disorders. The neurological symptoms are caused by the edema and degeneration of the brain and spinal cord due to vitamin B1 deficiency. The above changes are most prominent in the peripheral nerves. The cranial nerves of the extremities and the terminal branches of the vagus nerve are also more susceptible, and the peripheral nerve neuritis often occurs. The above severe cases of eye movement disorders, ataxia, and occasional retinal hemorrhage are now rare.

Niacin deficiency accompanied by mental disorders, also known as pellagra or Pellagra disease caused by niacin deficiency, such as inadequate food intake, chronic alcoholism and long-term diarrhea, niacin deficiency can lead to cerebral cortex, white matter The basal ganglia of the pituitary cells and the posterior and lateral bundles of the spinal cord are degenerated to cause mental disorders. Some people think that niacin is a polymethyl receptor, and its deficiency can lead to an increase in catecholamine methylation products and the emergence of mental disorders.

It has been reported in recent years that folic acid and vitamin B12 deficiency may play a leading role in some psychiatric diseases, and folic acid has been confirmed in depression and schizophrenia-like diseases. Folate deficiency may be associated with dementia in elderly patients with mental disorders.

Examine

an examination

Related inspection

Vitamin B6 Brain Doppler Ultrasound (TCD) Brain CT examination

Examination and diagnosis of nutritional metabolism deficiency

Clinical symptoms:

1, vitamin B1 deficiency (thiamine deficiency) with psychiatric symptoms

(1) Mental disorders: depression; governance disorders; disturbance of consciousness can be expressed as a state of paralysis.

(2) Neurological symptoms: neuritis, nystagmus, and occasional retinal hemorrhage.

2. Niacin deficiency is accompanied by mental disorders.

(1) Mental disorders: 1 neurasthenic syndrome: often appear in the early stage of the disease or milder 2 Depressive state: often accompanied by irritability, self-blame and suicide attempt to commit suicide, etc. occur in the disease process. 3 tension syndrome: tension excitement or tension stiffness similar to schizophrenia tension type 4 consciousness disorder: occurs in patients with acute onset of the disease in the late stage of the patient may appear blurred consciousness, sputum, or disordered state It can cause a high rate of coma and is called niacin-deficient encephalopathy. At this time, there are often neurological symptoms and characteristics. 5 Chronic encephalopathy syndrome: patients with chronic phase may have unresponsiveness, memory, and computational power loss. The action is awkward and slow, and in the later stage, the symptoms of Korsakov syndrome or dementia may be seen. 6 a small number can be manifested as encephalopathy: clinically, mainly with disturbance of consciousness, and with heavier neurological symptoms and signs.

(2) Neurological symptoms: nystagmus, pupillary changes (pupil enlargement, slow light reflex), positive pyramidal tract muscle tone, abnormal sensation of peripheral neuritis and epileptic seizures, such as subacute spinal cord combined degeneration Deep sensory motor disorders and mutual dyskinesia can occur.

(3) physical symptoms: glossitis, strawberry tongue; exfoliative dermatitis; gastrointestinal dysfunction. The most obvious complication of diarrhea dermatitis plus dementia is often called niacin deficiency.

Diagnosis: 1. Relevant evidence of disease-deficient diseases such as niacin vitamin B1 and folate deficiency

2. There are symptoms and signs of abnormal dysfunction caused by lack of nutrient metabolism.

3, mental symptoms change with the development of nutritional metabolic deficiency symptoms, that is, mental symptoms appear after physical diseases, and developmental changes have a parallel relationship with physical diseases.

4, related nutrition (nicotinic acid vitamin B1 and folic acid, etc.) treatment has significant effect

5, should be associated with other functional decline associated with mental disorders and other functional psychosis such as schizophrenia, snoring and depression.

Diagnosis

Differential diagnosis

Nutrient metabolism lacks confusing symptoms

Malnutrition in a broad sense should include both undernutrition or deficiency and overnutrition. The former is only discussed. Malnutrition often occurs in a number of medical and surgical causes, such as chronic diarrhea, short bowel syndrome, and malabsorption. The non-medical cause of malnutrition is a shortage of poor food. Lack of nutritional knowledge, parents ignore scientific feeding methods. Malnourished patients in developed countries can usually be treated by treating the primary disease, providing an appropriate diet, educating parents and carefully following up. But in many third world countries, malnutrition is the leading cause of child death. There are complex interactions between malnutrition, social habits, the environment, and acute and chronic infections, and treatment is very difficult, and it is not just a matter of providing the right food.