Mental impairment

Decreased activity of the thyroid gland results in hypothyroidism and, in severe cases, myxoedema. It is often of immunological origin and the manifestations are low metabolic rate, slow speech, lethargy, bradycardia, increased sensitivity to cold, and mental impairment. Myxoedema includes a characteristic thickening of the skin. Therapy of thyroid tumours is another cause of hypothyroidism. Thyroid deficiency... 

At blood levels of 0.02 g%-0.09 g% (4.34 to 19.5 mmol/L) may see some prolonged reaction time and muscular incoordination At blood levels from 0.1 g%-0.2g% (21.7 to 43.4 mmol/L) may see obvious prolonged reaction time, obvious incoordination and ataxia, and mental impairment At blood levels from 0.2 g% to 0.3g% (43.4 to 65.1 mmol/L) marked ataxia, some dysarthria, and possible nausea and vomiting At blood levels from 0.3 g% to 0.4g% (61.5 to 86.8 mmol/L) severe dysarthria, amnesia, and hypothermia... 

Carlin, A. S., Grant, 1., Adams, K. M., and Reed, R. (1979) Is phencyclidine (PCP) abuse associated with organic mental impairment Am. J. Drug Alcohol Abuse, 6 273-281. 

Phenylalanine hydroxylase (PH) which requires tetrahydrobiopterin (BH4) as a cofactor, is defective in cases of phenylketonuria (PKU). This is a rare (prevalence 1 / 15 000 in the United Kingdom) genetic condition characterized by fair complexion, learning difficulties and mental impairment. If PH is either not present in the hepatocytes or is unable to bind BH4 and is therefore non functional, phenylalanine accumulates within the cells. Enzymes in minor pathways which are normally not very active metabolize phenylalanine ultimately to phenylpyruvate (i.e. a phenylketone). To use the traffic flow analogy introduced in Chapter 1, the main road is blocked so vehicles are forced along side roads. Phenylpyruvate is excreted in the urine (phenyl-ketone-uria), where it may be detected but a confirmatory blood test is required for a reliable diagnosis of PKU to be made. 

Fragile X syndrome is the leading inherited cause of mental retardation in humans. It affects about 1 out of 2000 males and about 1 out of 4000 females. The degree of mental retardation is quite variable, from a mild mental impairment to severe mental retardation. The disease is frequently more serious in males than females males have only the defective X chromosome, whereas females have one normal X chromosome to go along with the defective one. There is no specific treatment for Fragile X syndrome. 

Parkinsonism, or Parkinson s disease, is named for James Parkinson who first described the disease back in 1817. It is nsnally a disease of the elderly characterized by a spectrnm of movement disorders involnntary movements, rigidity, slowness, and loss of balance. It may progress to mental impairment, including depression. This is basically the same spectrum of movement disorders sometimes seen in schizophrenia patients taking dopamine antagonists. This snggests that parkinsonism may reflect, in some manner, a deficit in dopamine activity. 

Noncompliance is a signihcant problem, with almost 50% of elderly patients failing to take their medications as prescribed. Some of the reasons for noncompliance are inability to pay for the drug, side effects, mental impairment, and inability to understand complex instructions. 

The lack of evidence of severe mental or emotional disturbances, even In volunteers who were observed to experience intense and persistent cardiovascular effects, is noteworthy. Although DMHP acetate elicits far greater cardiovascular consequences than other canna-binoids, It appears to Induce less severe mental impairment. It Is possible that careful screening and a supportive test milieu tend to minimize the occurrence of adverse mental effects. 

Folic acid deficiency can cause mental retardation in babies. That s a fact. So researchers at the University of Kentucky wondered whether a deficiency later in life could be associated with the mental impairment that sometimes characterizes aging. They elected to study a group of elderly Minnesota nuns who were keen on contributing to the advancement of science. Nuns are good subjects for studies on aging, because they tend... 

Pathophysiologically, constipation generally results from disordered colonic transit or anorectal function as a result of a primary motility disturbance, certain drugs, or in association with a large number of systemic diseases that affect the gastrointestinal tract. Constipation from any cause may be exacerbated by chronic illnesses that lead to physical or mental impairment and result in inactivity or physical immobility. Additional contributing factors may include a lack of fiber in the diet, generalized muscle weakness, and possibly stress and anxiety. 

Sibutramine (Meridia), a weight-loss drug introduced in 1998, inhibits the reuptake of the brain chemicals norepinephrine, dopamine, and serotonin, but does not promote monoamine release like the amphetamines. Yet the drug has been linked to serious side effects, including rapid heart rate, increased blood pressure, heart disease, stroke, seizure, and mental impairments. In March 2002, Italy s Health Ministry announced that it was immediately withdrawing all sibutramine products from the market due to health-related problems. Also, Meridia was the subject of a class action lawsuit filed in the United States. 

Chronic nitrous oxide abuse can remove a lot of vitamin B12 from the bloodstream. B12 (cobalamin) is necessary for the creation of blood cells and neurotransmitters, as well as the protective layers that cover nerves. This results in nerve damage and pain balancing, walking, and concentration difficulties mental impairment mood disturbances (such as depression) and other physical problems. Chronic nitrous oxide use may also interfere with the production in bone marrow of white blood cells and red blood cells. Treatment with intramuscular injections of B12 may reverse these symptoms. 

Anyone with the condition phenylketonuria (PKU), a metabolic disorder, should be particularly careful about nitrous oxide use. Individuals with PKU require a diet that is high in protein in low in animal fats, which frequently results in a vitamin B12 deficiency. Nitrous oxide can remove even more B12 from these individuals bloodstreams, possibly causing mental impairments, as well as severe nerve and brain damage. 

In addition to sexual harassment and accommodation of religious beliefs, equal treatment for individuals with disabilities is a significant issue for the treatment of both employees and customers. The Americans with Disabilities Act provides equal opportunity for persons who are disabled in the workplace. This act prohibits discrimination in all aspects of employment from hiring to firing, similar to practices that are covered by equal opportunity employment laws. Persons are considered disabled if they have either a physical or mental impairment that significantly limits one or more major life activities or have a record of impairment. Also, discrimination against a person who has a relationship with a disabled person is prohibited. 

The majority of patients recover and in these the further prognosis is good. Bonham Carter et al. (B5) noted normal growth and development during a 2-year follow-up. Forfar et al. (F7) noted similar full physical and biochemical recovery with no subsequent impairment of intelligence. Recovery may, however, occur in the physical sense but with mental impairment (C3). 

The physical and behavioral features of the disease in female patients are usually milder than in affected males. Somatic features may be absent or mild, although the faces of mentally retarded females tend to resemble those of male patients with advancing age. The intelligence deficit of female patients is less severe, with most patients having mild-to-borderline mental impairment. There is evidence of an increase in psychological and psychiatric problems among female patients. 

Male fetuses with 50 to 230 copies of the repeat should be asymptomatic, whereas those with more than 230 copies will have fragile X syndrome. Female fetuses with 50 to 230 copies also will be asymptomatic however, it is difficult to predict the extent of mental retardation in female fetuses with more than 230 copies of the repeat. Although hypermethylation of the CpG island is a poor prognostic indicator, it is not always present in DNA extracted from chorionic villus samples (Sutherland et al., 1991). Empiric data showing that female carriers with full mutations have nearly a 50% risk of mental impairment should be considered reliable. 

To practice applying the four principles of spellbinding, the reader can simply recall how individuals act when intoxicated with alcohol. Typically, people intoxicated with alcohols do not realize how impaired they have become when they become emotionally distressed, they blame it on someone or something other than alcohol intoxication, often becoming depressed or belligerent they often think that they feel better than ever when they are in reality mentally impaired and behaving badly and finally, they can do stupid things and even perpetrate violence that is wholly out of character for them when sober. 

Not only do the stimulants damage and disable the brain, but scientific research has also demonstrated how these physical disabilities are manifested in behavior changes. The stimulants impair behavior by crushing spontaneity and inducing compulsive behaviors. The less spontaneous, more compulsive children are seen as improved when in fact they are biologically and mentally impaired. The effect of the stimulants provides a clear-cut illustration of the brain-disabling principles described in chapter 1. 

From alcohol and methamphetamine to Prozac, Valium, lithium, and Zyprexa, psychoactive substances disguise their adverse mental effects for the user. A person grossly mentally impaired by stimulants, benzodiazepine tranquilizers, mood stabilizers, or neuroleptics is likely to have little idea about how dysfunctional he or she has become. When the individual does perceive a change in himself or herself, positive or negative, it is almost never attributed to the causative agent the drug. If the individual feels euphoric, it is attributed to good fortune and especially... 

Preliminary open-label data show that oral zuclopenthixol may be effective in reducing aggression in mentally impaired children... 

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