Neuropsychiatric syndrome

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. 

The exclusion of organic disease as the cause of a neuropsychiatric syndrome can be difficult. In this context, among other tests, lumbar puncture is indicated because many diseases of the brain are associated with a barrier disorder or an increased cell count. Both findings, sensitive yet nonspecific, are suggestive of central nervous system disease. Apart from these two nonspecific alterations, targeted CSF analysis is an important additional tool, depending on the clinical setting (F4, R6, T2). 

In addition, the alcohol addicts are liable to other neuropsychiatric syndrome (Korsakoff s psychosis) which is associated with hallucination, suicidal tendencies and encephalopathy. They may also suffer from hyperlipidemia, hyperuricemia, pancreatitis and hepatitis. 

Complicating the proper assessment and, by implication, the most appropriate therapy for many patients, is the very real possibility of neuropsychiatric syndromes that may mimic classic psychiatric disorders, exacerbate them, or coexist with such disorders as major depression, panic attacks, and brief reactive psychosis. Thus, the CNS may be affected by various primary malignancies or secondary metastases cardiovascular disorders, leading to ischemic episodes or hemorrhagic events and several HIV-related complications. 

Alzheimer s disease (AD) is the most common neurodegenerative disease in the elderly. Prevalence increases with age and by the year 2050 it has been estimated that world-wide 1 out of 85 persons will suffer from AD (Brookmeyer et ah, 2007). AD is clinically characterized by progressive memory deficits, speech problems, and visuospatial orientation. As the disease advances, the patient my develop apraxia (loss of the ability to execute or cany out learned purposeful movements), and requires help in performing activities of daily living. In moderate and severe stages of the disease, AD patients may show signs of neuropsychiatric syndromes like labile affect, aggression, hallucinations, sleep disturbances, and apathy. 

Neuropsychiatric syndromes (conversion disorder, panic disorder)... 

Hepatic encephalopathy is a neuropsychiatric syndrome which may complicate almost all types of liver disease. It may occur intermittently and be reversible or may occur acutely, with rapid progression to coma and death. Mrs MW presented with signs of hepatic encephalopathy including flapping tremor of the hands, intellectual deterioration, slurred speech, confusion, drowsiness and irritability. 

Meeks TW, Ropacki SA, Jeste DV. 2006. The neurobiology of neuropsychiatric syndromes in dementia. Curr Opin Psychiatry 19 581-586. 

Schwarzkopf SB, Bruno JP, Mitra T, Ison JR (1996) Effects of haloperidol and SCH 23390 on acoustic startle in animals depleted of dopamine as neonates Implications for neuropsychiatric syndromes. Psychopharmacology (Berl) 723 258-266. 

Isoniazid can cause neuropsychiatric syndromes, including euphoria, transient impairment of memory, separation of ideas and reality, loss of self-control, psychoses (421), and obsessive-compulsive neurosis (422). Isoniazid should be used with caution in patients with pre-existing psychoses, as it can cause relapse of paranoid schizophrenia (423). Patients on chronic dialysis appear to be vulnerable to neurological adverse drug reactions, because of abnormal metabolism of uremic toxins. It is therefore recommended that a... 

The efficacy of clozapine has been described in 60 patients with levodopa-induced neuropsychiatric syndromes (32 assigned to the active drug and 28 to placebo) (72). The mean age was 72 years, the mean duration of disease was 12 years (Hoehn and Yahr stage 3.2), and the mean levodopa dosage was 774 mg/day. At a dose of up to 50 mg/day, clozapine significantly improved psychotic features, with minimal effects on parkinsonian symptoms. Clozapine caused somnolence but was otherwise well tolerated. 

Loss-of-function mutations in members of the Neuroligin (NL) family of trans-synaptic cell adhesion molecules have been implicated in human autism and mental retardation (Chih et al., 2004 Comoletti et al., 2004 Jamain et al 2003 Laumonnier et al., 2004 Yan et al, 2005). At the time of writing, neuroligin mutations represent owe of only a few independently replicated, functional, genetic mutation links to idiopathic autism not associated with a broader neuropsychiatric syndrome (Chih et al., 2004 Comoletti et al., 2004 Jamain et al., 2003 Laumonnier et al., 2004 Yan et al., 2005). 

Hepatic encephalopathy (HE) is a neuropsychiatric syndrome associated with severe, acute and chronic liver failure. According to the recommendations of a working party (Ferenci et al 2002) held at the d"" World Congress of Gastroenterology in Vienna in 1998, 3 types of HE should be differentiated, on principle ... 

Cook, C.C., Hailwood, P.M., and Thomson, A.D., 1998. B Vitamin deflciency and neuropsychiatric syndromes in alcohol misuse. Alcohol and Alcoholism. 33 317-336. 

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