Organic brain disorder

    
      Re: Organic brain disorder
    


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Posted by CCF Neuro MD on June 10, 1997 at 10:35:00:

In Reply to: Organic brain disorder posted by Lisa Fuller on May 31, 1997 at 20:57:28:

: I am an Occpational Therapist working in a state
  developemental center. Many of my patients are
  diagnosed M/R with organic brain disorder,
  disfunction or disease.As far as I'm concerned,
   this means that something, progressive and
  degererative, is happening to these clients, and no one
  cares to look for an accurate dx because these
  individuals are retarted and institutionalized.Many
  of these clients have a common history, and have lost
  a lot of function over time.Could you give me some of
  the most common neuromyopathies, or neurological
  syndromes that might apply to clients, with progressive
  M/R and movement disorder, symptomology.
  Many of these patients had a short period of normal
  or near normal developement.Onset of symptoms was 1 to
  3 yrs. Often their 1st dx. Was childhood scizophenia.
  Behavior problems progressed until, most patients
  were institutionalized, between on average ages 5 to
  10 yrs. old. Most were put on thorazine or melarill.
  Most of lost motor skills, speech and ADL skills.
  Most are age 30 to 40 now, still taking the same meds.
  for 15 to 30 yrs.Most now have a constellation of  
  movement disorders, some cannot even eat or
  walk anymore.Assuming that the Thorazine or Mellaril
  didn't cause all of these problems,what are the most
  probable causes of the degeneration. Many, now have
  a dx of PDD, but their histories do not always mention
  ritualistic behaviors or steriotypical movements.
  Many histories mentioned, delayed or abnormal speech,
  hyperactivity, poor impulse control, tantrums, and
  self injurous behavior.
               Thanks for your help!!!
=====================================================================================================
Hello Lisa,

Your question is too complicated to answer without having seen and performing a complete history and physical on the patients which you are referring to.  The term mental retardation simply implies that there is brain damage that has been severe enough to cause intellectual decline in the patient.  When there is a continuing decline of a patients cognitive status we use the term dementia.  There are numerous neurodegenerative disorders that can cause a dementing illness and movement disorders.  It is well beyond the scope of this forum to discuss each of these disorders.  I would suggest that if you have patients that you are concerned about  some underlying disorder that has been missed on the initial evaluation, you should work with the primary physician involved and seek a consultation with a neurologist in those cases where necessary.
This information is provided general medical education purposes only.