Exposure to such heavy metals as mercury and bromide, chronic contact with various insecticides, and use of various classes of drugs of abuse may produce dementia. Many other agents can produce dementia as a result of their persisting effects. Marchiafava-Bignami disease Wernicke-Korsakoff syndrome Hepatic encephalopathy Delirium tremens Withdrawal seizuresĮpisodic dyscontrol (pathological intoxication) Alcoholic hallucinosis Head injury caused by recurrent use of alcohol and cross-sensitive drugs, respiratory disease related to smoking, central nervous system hemorrhage secondary to trauma, chronic hypoxia related to recurrent seizure activity, folic acid deficiency, and higher rates of some neoplasms among those with alcoholism (Table 11-8). The dementia may be affected by periodic superimposed delirious states including thoseĬentral Nervous System Sequelae of Alcohol Abuse Increasing memory loss, worsening cognitive processing, and concrete thinking follow. The amount of deterioration is related to age, number of episodes of heavy drinking, and total amount of alcohol consumed over time.Īlcohol-induced dementia, secondary to the toxic effects of alcohol, develops insidiously and often presents initially with changes in personality. The frontal lobes are the most affected, followed by parietal and temporal areas. The CT scan shows cortical atrophy and ventricular dilatation after about 10 years with neuronal loss, pigmentary degeneration, and glial proliferation. Dementia is more common in individuals with alcoholism who are malnourished. Alcohol-induced dementia is a relatively late occurrence, generally following 15 to 20 years of heavy drinking. ![]() Severe alcohol dependence is the third leading cause of dementia. In addition to various nutritional deficiencies and the toxic effects of alcohol itself, alcohol abusers are more prone to develop dementia as a result of head trauma and chronic hepatic encephalopathy. The diagnosis of alcohol persisting dementia requires that the cognitive changes persist after the cessation of alcohol use and are not the result of changes in mentation associated amnestic episodes (blackouts), or Wernicke-Korsakoff syndrome. The most common dementias in this category are those associated with alcohol abuse, accounting for about 10% of all dementias. In instances in which the features of dementia result from central nervous system effects of a medication, toxin, or drug of abuse (including alcohol), the diagnosis of dementia due to the persisting effects of a substance should be made.
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