alcohol toxic paranoia (alcoholic dclusiveness) patients in the case of a clear sense of jealousy, delusions and paranoia emerged, the former more common clinical . Spouses of patients suspected of infidelity for no reason, this often rage reactions, can also lead to the suspicion of an attack object or spouse, and sometimes lead to murder consequences. Also known as the wine past its toxic jealousy (alcoliolic jealousy). Jealousy, delusions of patients with long-term alcohol consumption usually occur leading to a decline in sexual function. wine toxic paranoia slow onset, persistent, such as long-term adherence and alcohol can be gradually restored.[Cause]
neural spines polycythemia is caused by what the?
generally agreed that neural spines polycythemia (neuroacanthocytosis, NA) is a rare genetic disease , of which the main type of ataxia, autosomal recessive inheritance was to hyperactivity main types, showing autosomal dominant inheritance, with occasional sporadic cases. Also with the X chromosome that may be related to sex-linked genetic defect genetic disease.
(B) the pathogenesis
NA pathological changes involving the brain (caudate nucleus, severe neuron loss with glial cell proliferation, globus pallidus lesions less), the spinal cord (spinal cord anterior horn severe neuron loss), peripheral nerve (patchy demyelination of myelinated fibers, neurons, muscular atrophy), and other parts.
autopsy gross specimen shows brain atrophy and caudate nucleus, lateral expansion. Microscope, the small neurons and striatal medium-sized neuronal loss, extensive astrocytic reaction. The caudate nucleus head and body atrophy mainly the number of neurons decreased significantly. globus pallidus has the same change but to a lesser extent. In some cases thalamus, substantia nigra and spinal cord anterior horn neuronal loss and a mild glial cell response, while the remaining parts of the brain is relatively no change. individual cases that the brain frontal cortex layer 3 pyramidal cells accumulate in different parts of the neuron and the huge phenomenon. But so far the lack of large sample pathology report.[Sign]
neural spines polycythemia early symptoms?
1. polycythemia neural spines common in adolescence or early adulthood, age 8 to 62 years of age; duration of 7 to 24 years, the longest survival of 33 years; men in the female, male to female ratio of approximately 1.8:1.
2.NA the most prominent clinical manifestations of dyskinesia, involuntary movements of the orofacial, limb chorea (exactly like the HD) the most common. Usually eating difficulties, gait instability, when a self-Yaochun, tongue and so on. Other movement disorders are dystonia, akinetic muscle rigidity, Tourette's, Parkinson's syndrome (PDS) and so on. PDS more common in younger patients, in the course of 3 to 7 years, there may be simultaneous with the movement disorders.
3. personality changes and psychiatric symptoms is also its common symptoms; about half of patients may have decreased sexual intelligence; about 1 / 3 of patients, there may be seizures, with tonic spastic body attacks more common.
5.Haidie, etc. (1991) NA divided into three types:
(1) Bassen-Komzweig syndrome : no β-lipoprotein, also known as hyperlipidemia, an autosomal recessive genetic disease. clinical manifestations of spine polycythemia, β lipoprotein deficiency, fat malabsorption, ataxia, retinopathy, may be associated with muscle atrophy, gonadal atrophy, arched feet and so on.
(2) Mcleod syndrome: the X-linked recessive genetic disease. incidence of more than 30 to 40 years old, for a variety of clinical manifestations of movement disorders, often reflex, myopathy, cardiomyopathy, serum creatine kinase (CK) activity increased and sustained hemolytic state. The disease is characterized by red blood cell surface antigen of the Kell antigen and xK antigen significantly decreased or even disappeared.
(3) Levin-Critchley syndrome: also known as chorea - spine polycythemia. Mcleod syndrome with clinical manifestations similar, but red blood cell surface antigen expression of Kell antigens and xK normal serum lipoprotein levels are within normal limits.
NA The diagnosis relies on clinical manifestations and laboratory examinations. Typical clinical manifestations, peripheral blood red blood cell count greater than 3% of the spine and increased serum CK can be diagnosed.[Aftertreat]
neural spines polycythemia ate?[Prevent]
alcoholic jealousy, delusions should be how to prevent?
1, anti-psychotic treatment. according to the disease can be selected as appropriate: (1) chlorpromazine 25mg, 2 / d; (2) perphenazine 2mg ~ 4mg, 2 / d; (3) clozapine 12.5mg ~ 25mg, 2 / d. 2, the alcohol treatment (1) one-off wine: patients with severe and severe withdrawal reactions that can be used with alcohol dependence have cross-benzodiazepine class of substitution, replacement is successful, then withdraw to stop drugs. Optional ① stability 10mg, or 5mg, 2 / d; ② good Jing'an be 0.4mg, 2 / d; ③ clonazepam 1.0mg, 2 / d. (2) aversion therapy: 20mg subcutaneous injection of apomorphine after the patient smell alcohol, when a patient is about to vomiting, the patient drinking a cup. This daily or every other day for 10 to 30 times, wine and alcohol can be formed on the vomiting reflex, to stop drinking purposes. (3) taking anti-alcohol agent: Disulfiram 0.25 or 0.5g, l / d, 1 ~ 3 weeks for a course of treatment, coronary heart disease and acute intoxication state disabled. 3, Chinese medicine, diagnosis and treatment. 4, psychiatric, occupational and recreational therapy. Nursing: 1, according to general psychiatric care routine, the impulse of secondary wounding and suicide, and suicide by anti-impulsive wounding special care routine. 2, alcohol, you should closely observe whether the mental and physical withdrawal symptoms occur, to encourage and help patients successfully stop drinking. 3, strengthen psychological care, patients are urged to participate in physical activity and occupational and recreational therapy activities. Discharge criteria: mental symptoms, insight recovery; the spirit of ethanol and physical dependence disappears.[Treat]
neural spines polycythemia precautions before treatment?
so far no effective treatment. sedatives such as phenobarbital, diazepam, haloperidol personality, behavioral disorders, physical chorea and orofacial dyskinesia may be effective, but easy to induce PDS. Dopaminergic drugs on the PDS may be helpful.
(b) the prognosis
duration of 7 to 24 years, the longest survival of 33 years; about half of patients There may be loss of intelligence; about 1 / 3 of patients, there may be seizures, tonic spasms of the body to attack more common.
No related information
alcoholic jealousy, delusions should be how?
for a comprehensive physical examination and blood, urine, then routine, liver and kidney function tests, blood sugar, enzymes and blood electrolyte testing; eeg , head CT, liver and gallbladder B-and upper gastrointestinal barium meal examination. rule out physical illness due to schizophrenia or mental disorders.[Diff]
alcoholic hallucinations: hallucinations toxic wine (alcohljic hallucinosis) This is an illusion caused due to chronic alcohol consumption status. Patients reduce or stop drinking suddenly after 1 to 2 days a large number of rich vivid hallucinations, illusions as to the master. Common primitive visual hallucinations, and a critical and command auditory hallucinations. In the illusion based on wishful thinking and the corresponding fragment may appear tense fear or depression. During the incubation period, the patient's state of consciousness clear, there is no obvious psychomotor excitement and plants neurological symptoms of hyperthyroidism. wine toxic hallucinations duration variable, ranging from a few hours, the longest not more than six months.
alcoholic paranoid state: alcoholic paranoid state (alcoholic paranoidstate) in patients with chronic alcoholism suspicions of their spouses, usually jealousy, delusions, paranoia can also be found. Finally, there is that this class of cases are chronic schizophrenia and chronic alcoholism is just coincidence.
for a comprehensive physical examination and blood, urine, then routine, liver and kidney function tests, blood sugar, enzymes and blood electrolyte testing; EEG, head CT, liver and gallbladder B- and upper gastrointestinal barium meal examination. rule out physical illness due to schizophrenia or mental disorders.[Disease]
alcoholic jealousy, delusions related diseases
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