Encephalopathy mental impairment

Byers (1959) reviewed the outcome of 45 children previously hospitalized with lead poisoning and found one third to be mentally deficient. Perlstein and Attala (1966) reported that 39% of 425 children with lead poisoning showed neurological impairment in follow-up examinations. This was most marked in those infants whose symptoms included encephalopathy (i.e. 81% of 59). In a review of the literature by Wiener (1970) a link between some degree of mental impairment and lead poisoning was established. 

Encephalopathy - Impaired cognition confusion obtundation altered mental status auditory/visual hallucinations psychosis (delirium, paranoia) mood changes (eg, mania, agitation, combativeness) diffuse hypotonus hyperreflexia myoclonus tremor asterixis involuntary movements major motor seizures lethargy/stupor/coma diffuse weakness. Approximately one-third of patients with a diagnosis of encephalopathy may have had... 

The spectrum of cognitive deficits associated with chronic alcohol use extends to the extreme of Wernicke s encephalopathy and Korsakoff s psychosis. Wernicke s encephalopathy is an acute neurologic syndrome caused by thiamine deficiency. Symptoms include mental confusion, ophthalmoplegia, and ataxia. Many of these symptoms reverse with administration of thiamine however about 50% of patients are left with some degree of ataxia. Left untreated, Wernicke s encephalopathy can progress to stupor, coma, and death. Approximately 80% to 90% of alcoholics treated for Wernicke s encephalopathy are left with Korsakoff s psychosis, a syndrome of impaired learning and recent memory produced by lesions of the medial dorsal nuclei of the thalamus. 

Chronic encephalopathy 80-100 Various impaired clinical measures of mental functioning e. g., mental retardation U.S. CDC—PbB >70 is an "acute" medical emergency ... 

Since the first reports from Australia and the observations in France (26 ) encephalopathy has been irrefutably shown to be a complication, not only of bismuth subgallate but also of other bismuth salts such as the subnitrate, carbonate and silicate. More than a hundred cases of bismuth encephalopathy have now been reported. The prodromal stage of bismuth encephalopathy is characterized by headache, insomnia, impairment of mental functions, asthenia and confu-sional states. After some time an overt encephalopathy develops abruptly, generally characterized by (1) psychosis, often with excitation and hostility, and finally coma, (2) myoclonic jerks, progressing to myoclonic crises, (3) ataxia and dysarthria, and (4) convulsions if generalized, these states are often resistant to anticonvulsant drugs. 

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