Alcoholic brain atrophy
Introduction
Introduction to alcoholic brain atrophy Alcoholic brain atrophy (alcoholiccerebralatrophy) refers to the irreversible reduction of brain tissue caused by chronic alcohol consumption. It is controversial whether this disease constitutes an independent clinical pathological disease. Some authors believe that alcoholic brain atrophy is a pathological concept. The term was first derived from the study of cerebral angiography, especially for relatively young alcoholics, with or without symptoms of cerebral lesions. The cerebral angiography showed lateral ventricle enlargement and widening of the frontal sulcus. Modern imaging studies have corresponding findings. The mechanism of its occurrence is unknown, which may be related to the direct damage of alcohol to the brain and nutritional disorders, especially the lack of vitamin B1. It is more common in men and middle-aged people who drink a lot of alcohol for a long time. The incidence is concealed and progresses slowly. Early on, there are often anxiety, headache, insomnia, fatigue and so on. Gradual mental decline and personality changes. In addition, some patients may also have peripheral neuropathy, muscle atrophy, and even severe toxicities such as tremors, hallucinations, delusions and seizures. Head CT shows lateral cerebral symmetry enlargement, sulci, hemispherical fissure and lateral fissure Widening and other manifestations of brain atrophy. basic knowledge Sickness ratio: 0.0012% Susceptible people: more common in middle-aged and elderly Mode of infection: non-infectious Complications: muscle atrophy paranoia epilepsy alcoholism
Cause
Causes of alcoholic brain atrophy
(1) Causes of the disease
It has indeed been confirmed that a large number of uncontrolled drinking alcohols have a great detrimental effect on many organ systems of the body, and the nervous system is one of the main target organs of alcohol abuse.
(two) pathogenesis
The pathogenesis of brain atrophy caused by alcoholism is unclear, which may be caused by various reasons, such as vitamin B1 deficiency or nutritional disorders, but it is also thought that the direct damage of alcohol to the brain causes neuronal loss. Some literature believes that: trial It is proved that alcohol can dissolve in fat, but it can also dissolve fat. The highest fat content in various organs of the human body is nerve tissue, and the brain is in the first place. Long-term chronic alcohol exposure and damage to neurons cause corresponding dysfunction is inevitable.
A CT scan revealed a change in brain atrophy, such as deepening of the sulci, widening of the cerebral fissure, and enlargement of the symmetry of the ventricle. It does not represent an irreversible loss of brain tissue. In recent years, CT or MRI studies have found that CT findings have been observed by some alcoholics. Reversible to varying degrees, this reversibility indicates that the fluid in the brain has metastasized rather than lost brain tissue, which may be related to the return of water and electrolytes in the brain after alcohol withdrawal, and may also be related to glial cells and nerves. Regeneration of the protein is related.
The relationship between these imaging findings and clinical findings is far from clear. Some patients with brain atrophy are often accompanied by obvious alcoholic complications. There are reports of pathological data of Wernicke-Korsakoff syndrome, about 1/4 of the lateral ventricle, third The ventricles are enlarged, and the frontal cerebral palsy is atrophied. Other alcoholics have a cerebral ventricle due to recurrent seizure history, or liver disease, brain trauma, and other factors. However, some alcoholics have found that the ventricles are enlarged, but in Throughout the process, routine neurological examinations and intelligent state tests did not reveal symptoms and signs of neuropsychiatric disorders.
Prevention
Alcoholic brain atrophy prevention
A small amount of reasonable drinking may have certain benefits for the human body. Avoiding long-term heavy drinking is the main measure to prevent brain atrophy caused by alcoholism.
Complication
Alcoholic brain atrophy complications Complications, muscle atrophy, paranoia, epilepsy, alcoholism
It can be associated with severe alcoholism such as peripheral neuropathy, muscle atrophy, tremors, hallucinations, delusions and seizures.
Symptom
Alcoholic brain atrophy symptoms Common symptoms Dementia anxiety fatigue illusion irritability tremor alcoholism muscle atrophy alcohol tremor
1. Brain atrophy is more common in men with a long history of heavy drinking, generally with chronic alcoholism, more common in middle-aged and elderly people, the incidence of insidious attacks, and gradually slow progress.
2. The main features are early anxiety, headache, insomnia, fatigue, etc., gradually appear mental retardation and personality changes, unless there is severe brain atrophy, generally no obvious dementia, can maintain good working ability for a long period of time, the patient complained Obvious memory loss, and can have computational power, judgment and analysis ability decline, a few Korsakoff psychosis manifestations of forgetfulness, fiction and disorientation, personality change can be selfish, life is sloppy, emotional instability, irritability, work efficiency Low, lack of responsibility, not listening to people's advice and interpersonal tensions, etc., in severe cases, there is a decline in intelligence and a significant decline in IQ.
3. Some patients may have peripheral neuropathy and muscle atrophy, and even severe toxic effects such as tremors, hallucinations, delusions and epileptic seizures.
4. Skull CT shows the cerebral sulcus widening, the cerebral gyrus becomes smaller, and the brain pool and ventricle enlargement and other brain atrophy.
Examine
Alcoholic brain atrophy
1. Determination of blood and urine alcohol concentration: There is a diagnosis and the degree of toxicity assessment.
2. Other blood tests: including blood biochemistry, liver function, kidney function, coagulation function and immunoglobulin.
3. Cerebrospinal fluid examination: There is a differential diagnosis.
4. ECG, EEG, brain CT or MRI examination: there is a diagnosis and identification significance.
5. Electromyography and neurophysiological examination: differential diagnosis.
Diagnosis
Diagnosis and identification of alcoholic brain atrophy
According to the patient's history of heavy drinking, those with typical clinical symptoms should be examined by CT. If CT has the above symptoms, the disease should be considered.
Brain atrophy, such as brain trauma, cerebral arteriosclerosis, Alzheimer's disease, and Pick disease, should be identified and excluded for a number of reasons.
