Re: irreversible organic brain disease

Posted By ccf neuro M.D. on May 15, 1997 at 20:43:39:

In Reply to: irreversible organic brain disease posted by Walter Futch on May 10, 1997 at 09:24:41:







: My eighty-one year old mother-in-law has recently
been diagnosed with irreversible organic brain disease.
Her original symptoms in November 1996 seemed to point
to depression but medication did not seem to help,
she now is being treated for paranoia.  She has been
treated for a number of years with thyroid supplement
for low thyriod and heart medication for atrial
fibrillation, but otherwise has been healthy.
What is irreversible organic brain disease?
What tests or studies should be used in the diagnosis?
What other diseases or conditions(especially
reversible ones) have similar symptoms?
What tests need to be done to rule  out  these
other conditions as possible causes?
Are there any therapies or medications that will help
the irreversible organic brain disease? paranoia?
depression?
Thank you for your help.



       =


"Irreversible organic brain disease" is an extremely vague, nonspecific term that essentially encompasses any nonpsychiatric disease of the brain that cannot be cured or reversed. Examples could include anything from a brain tumor to degenerative diseases such as Alzheimer's disease, progressive supranuclear palsy, or multisystem atrophy. Treatment would be tailored to the specifc cause of the deterioration, if it is known (if this is the most specifc diagnosis your doctor could give your mother, I suspect the cause or true underlying diagnosis is not known). The only "treatment" for Alzheimer's is an anticholinesterase drug. Two such drugs are currently available. Both have marginal overall effectiveness in improving symptoms but in selected individual patients there are occasional significant/noticable improvements. Side effects may include confusion, psychosis, diarrhea, abdominal pain, and liver damage, which must be monitored for periodically by blood tests. If your mother is suffering from another of
the neurodegenerative diseases, treatment options are limited to supportive therapy for individual specifc symptoms & complaints. Such diseases are, unfortunately, ususally terminal within sveral years of onset. If you feel the onset of illness was rapid in your mother, this would raise suspicion for a more unusual condition--- perhaps multiple small strokes in the brain ("multi-infarct dementia"), an infectious process in the brain like encephalitis or Creutzfeld-Jakob disease, or a cancer-related degeneration of the brain known as limbic encephalitis. None of these are nice things to have either. I would ask your mother's doctor if s/he can give you any more specific diagnosis. If so, we might be able to provide you with more spoecific information. If your mother lives near the Cleveland area or if you are interested in a second opinion regarding the diagnosis and treatability of your mother's illness, you could arrange an appointment for her by calling 1-800-223-2273 extension 45559. I would suggest a Dr.
Richard Lederman in particular.





and what are its usual symptoms.
The onset of her condition seemed rather sudden ( over a period of several weeks) does this seem to fit the