Mental disorders associated with Behcet's disease
Introduction
Introduction to mental disorders associated with Behcet's disease Behcet's disease is an eye-oral-genital triad, an autoimmune disease characterized by oral, genital ulcers and iridocyclitis. Most scholars believe that it is an autoimmune disease, related to viral and bacterial infections. Theories such as nutritional disorders and circulatory disorders have now been denied. Cavara et al (1954) proposed that central nervous system symptoms as the main clinical image called neurobehide disease, the mechanism of neuropsychiatric symptoms is still unclear. basic knowledge The proportion of illness: 0.015% Susceptible people: no specific people Mode of infection: non-infectious Complications: folliculitis nodular erythema
Cause
Causes of mental disorders associated with Behcet's disease
(1) Causes of the disease
Behcet's disease is an autoimmune disease, and the cause is still unclear. Behcet's disease is the main cause of the onset of mental disorders. The brain dysfunction leading to mental disorders is secondary to Behcet's disease, but not all of Behcet's disease. There is a mental disorder, so Behcet's disease is not the only cause of mental disorder. There may be other factors related to the occurrence of mental disorders, such as other biological factors, including the patient's gender, age, genetic factors, personality characteristics, and past The history of neuropsychiatry; psychological factors include stress, long-term psychological contradiction; environmental factors, such as overcrowding, noisy environment, humidity, air pollution, etc., all of which can become Beysts with mental disorders Promote factors.
(two) pathogenesis
The mechanism of neuropsychiatric symptoms is still unclear. According to pathological findings, it is mainly perivascular and meningeal cell infiltration and inflammatory edema and diffuse glial cell proliferation. The lesions are more common in brain stems (about 95%). Mainly invade the pons, midbrain, internal capsule and other parts.
Prevention
Prevention of mental disorders associated with Behcet's disease
There are no effective preventive measures for collagen system diseases. Good personality and psychology will help to reduce the occurrence of mental symptoms after illness.
Complication
Complications of mental disorders associated with Behcet's disease Complications, folliculitis, nodular erythema
1. Skin complications, almost all patients have skin nodular erythema, folliculitis, rash or pustular rash, but also non-specific allergic reactions of the skin: if sterile needles are used to penetrate the sterile skin, 24 to 28 hours Internal manifestations of nodules, induration, papules or small pustules;
2. Allergic small vasculitis of the cardiovascular system, superior vena cava syndrome, endarteritis, aortic regurgitation, peripheral aneurysm, etc.;
3. Brainstem syndrome of the nervous system, recurrent paroxysmal headache, etc.;
4. Gastrointestinal mucosal ulcer, perforation, proliferation, etc. of the gastrointestinal system; hyperthermia-like manifestations;
5. Rheumatoid-like pain in the joints of the extremities;
6. Large hemoptysis of the respiratory system, pulmonary vasculitis, etc.
Symptom
Symptoms of mental disorders associated with Behcet's disease Common symptoms Illusion mental disorder Auditory hallucinations Dementia Increased anxiety of the skull
The lesions are extensive, the symptoms are extremely complicated and diverse, and the clinical classification is generally divided into four types: brainstem type, meninges-spinal type, encephalitis type, and increased intracranial pressure. The mental disorders can be roughly classified into the following five categories:
1. Affective Disorder: It is characterized by forced crying and laughing. Others have emotional change, instability, euphoria, impatience, irritability or dullness, apathy, etc. Depression and anxiety are also more common and may be related to heart.
2. The state of illusion or delusion is murdered.
3. Split-like mental illness: performance excitement, resistance, bizarre behavior, auditory hallucinations or stupor.
4. Dementia status: The degree is light, comprehension, understanding, calculation, common sense, orientation, etc. can still be maintained, but lack of thinking, psychomotor inhibition, apathy, crying and laughing, some people think it is subcortical dementia or Axonal dementia is different from cortical dementia. The lesions are mainly brain stem, caudate nucleus, internal capsule, husk, hypothalamus and other parts. Pathological changes include perivascular cell infiltration, white matter and gray matter softening or thrombosis, and hemorrhage. Wait.
5. Consciousness disorder The most common state of drowsiness is that it tends to move toward a paralyzed state, but it is relatively short-lived.
Examine
Examination of mental disorders associated with Behcet's disease
Detailed physical examination: by examining the body and nervous system examinations. Use basic examinations: ECG, EEG, blood, urine routine, liver function. There is a problem with the EEG, and further CT and MRI can be performed. Suspected that there is inflammation in the brain to do a lumbar puncture test cerebrospinal fluid. Suspected of insufficient blood supply to the brain to do cerebral blood flow map.
Diagnosis
Diagnosis and diagnosis of mental disorders associated with Behcet's disease
Diagnostic criteria
For the diagnosis of mental disorders caused by all physical diseases, it is first necessary to determine that mental symptoms are caused by physical diseases. The diagnosis of mental disorders associated with Behcet's disease is no exception. A comprehensive understanding of medical history includes a complete history of physical illness and history of mental disorders. Detailed physical examinations and laboratory tests, certain necessary psychological tests, and the identification of the nature, characteristics and syndromes of psychiatric symptoms are prerequisites for a correct diagnosis, and a comprehensive assessment of the basis of the above-mentioned findings In order to make a correct diagnosis, it can be roughly divided into three steps.
1. Determine the presence and diagnosis of Behcet's disease, ie evidence of Behcet's disease.
2. Determine the nature, characteristics, and diagnosis of psychiatric symptoms, and carefully identify the following mental symptoms and the presence of symptom groups and their relationship to Behcet's disease:
1 intelligent damage syndrome;
2 amnesia syndrome;
3 personality changes;
4 disturbance of consciousness;
5 psychotic symptoms (such as hallucinations, delusions, nervous syndrome, etc.);
6 affective disorder syndrome (such as mania syndrome, depression syndrome, etc.);
7 dissociation (conversion) syndrome;
8 neurosis-like syndrome (such as anxiety syndrome, emotional vulnerability syndrome, etc.), mental symptoms can not be attributed to other mental illness.
3. Determine the relationship between Behcet's disease and psychiatric symptoms. If Behcet's disease is present first, psychiatric symptoms occur, psychiatric symptoms improve with the relief of physical diseases, or worsen due to its aggravation, that is, mental symptoms with Behcet's disease Changes in the development of symptoms can determine that mental symptoms are associated with Behcet's disease.
Differential diagnosis
It should be differentiated from other mental disorders caused by connective tissue diseases and other functional psychosis such as schizophrenia, snoring and depression.
