Neurological and neuropsychiatric disorder

Table 4.1 Involvement and status of glutamate transporters in neurological and neuropsychiatric disorders... 

Wichmann T., DeLong M.R. Deep brain stimulation for neurologic and neuropsychiatric disorders. Neuron, 2006, 52,197— 204. 

In zooo, the prevalence of cerebral palsy in metropolitan Adanta was 3.1 per 1000 8-year-olds. Of 10-year-old children, 23 of every 10,000 had cerebral palsy. Eighty-one percent of these children had spastic cerebral palsy. Seventy-five percent had one or more other disabilities (epilepsy, mental retardation, hearing loss, or vision impairment).7 Like many neurological and neuropsychiatric disorders, a diagnosis of cerebral palsy is a description of symptoms, not an identification of causes. 

Folate deficiency may promote neurological and neuropsychiatric disorders. 

Delayed neurologic and psychiatric disorders following acute arsine exposures have been reported (Frank 1976). Exposure concentrations were not provided, but duration of exposure ranged from 10 to 90 min. Within hours after the exposures, characteristic signs of arsine poisoning (e.g., hemolysis and hematuria) were observed. Polyneuropathies and neuropsychiatric syndromes were detected at 1-36 mon after the acute exposures to arsine. 

Neurological symptoms result from demyelination of the spinal cord and are potentially irreversible. The symptoms and signs characteristic of a vitamin B 2 deficiency include paresthesis of the hands and feet, decreased deep-tendon reflexes, unsteadiness, and potential psychiatric problems such as moodiness, hallucinations, delusions, and psychosis. Neuropsychiatric disorders sometimes develop independently of the anemia, particularly in elderly patients. Visual loss may develop as a result of optic atrophy. 

B. Survivors of serious poisoning may suffer numerous overt neurologic sequelae consistent with a hypoxic-ischemic insult, ranging from gross deficits such as parkinsonism and a persistent vegetative state to subtler personality and memory disorders. Various studies suggest that the incidence of subtle neuropsychiatric sequelae such as impaired memory and concentration and mood disorders may be as high as 47%. 

Thiamine deficiency is the established cause of Wernicke s encephalopathy (WE), an acute neurological disorder constituting one of two components of Wernicke-Korsakoff syndrome (WKS), a neuropsychiatric disorder characterized by ophthalmoplegia, gait ataxia and confusion/memory loss. Up to 80-90% of these patients with WE go on to develop the more debilitating chronic amnesic state, referred to as Korsakoff s psychosis. 

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