attention disorder
Introduction
Introduction Note that a person's mental activity selectively points to a certain goal. There are active and passive points. Attention barriers manifest themselves in changes in intensity, range, and persistence. Individuals feel threatened. If they are suspected of being seriously ill or think that others are going to persecute him, they often show increased vigilance and attention. Sleepiness, fatigue, depression, and often distraction are difficult to concentrate. Children with ADHD (MBD) due to dysfunction of the brain up-regulation system, insufficient cortical arousal, weakened control of the cortical descending motion center, resulting in short-term attention and constant movement, although intelligence is collected in the normal medical teaching Poor academic performance. The basic psychological barrier is the attention deficit.
Cause
Cause
Attention disorders are often accompanied by disturbances of consciousness. Any part of the brain lesions, especially a wide range of lesions, cause damage to attention, a decrease in arousal, a high level of lethargy or awakening, and a state of nervous anxiety, which affects attention. Continuous concentration, schizophrenia and mild dysfunction syndrome in children also have attention deficits. Children with ADHD (MBD) due to dysfunction of the brain up-regulation system, insufficient cortical arousal, weakened control of the cortical descending motion center, resulting in short-term attention and constant movement, although intelligence is collected in the normal medical teaching Poor academic performance. The basic psychological barrier is the attention deficit.
Examine
an examination
Related inspection
Brain CT examination EEG examination
Attention to obstacles is very common. For example, parents often complain that the childs attention is not concentrated. There are many small movements in class. He knows it himself, but the child cant correct it himself. This is one of the obstacles.
There are six types of attention barriers, namely:
1. Attention to enhance: There are two kinds of attention enhancement. One is to pay attention to something that is external. For example, a patient with a delusional concept often pays attention to a systematic reverie to pay attention to the actions of the person he suspects. Even some tiny details remain highly noticed and alert. The other is to point to some physiological activities of the patient itself, such as the suspected concept of neurotic patients. These patients often pay too much attention to their own health status or the morbid thinking content that makes him sad, and it is difficult for any other event to transfer them. attention. Increased attention can enhance or promote the development of mental symptoms.
2. Attention to weaken: the performance is that the active attention is obviously weakened, that is, the attention is not concentrated, the patient can not concentrate on a certain thing and keep it for a long time, so that the attention is easy to disperse, even if the book is read for a long time, the result Still not knowing what it is, just like I haven't read it. More common in neurasthenia and schizophrenia.
3. Transferring with the environment: Excitability is manifested as passive attention, but attention is not persistent, and the object of attention is constantly shifting. If the mania is in an excited state, the attention is easily attracted by the new phenomenon of the field in the surrounding environment, so that the topic and the content of the activity are constantly changing, and the attention cannot be sustained, and the accidental changes will be The patient's attention is drawn to the other side. In the case of acute mania, the inconsistency of the patient's speech is mainly due to the constant conversion of the object of attention and the too fast thinking association.
4. Attention to dullness: the patient's attention is difficult to concentrate and slow, but the attention to stability is less, the patient is completely correct to answer the first question, but he continues to ask the second and third questions. At the time, the response of others seems slow, mainly due to the slow excitement of attention and the slow process of association, which is more common in depression.
5. Attention to stenosis: the patient's attention range is significantly reduced, active attention is weakened, when the patient concentrates on a certain thing, and other things that are generally easy to evoke attention do not cause the patient's attention, see the state of paralysis and dementia.
6. Attention to fixation: the patient's attention to stability is particularly enhanced. Seen in healthy people and mental patients, such as some inventors and thinkers, fixed attention to certain concepts, strong concepts control their entire consciousness, especially this thinking and equivalent When there is a strong emotional response, depression, and patients with stubborn delusions, will always be fixed on these delusions. In patients with obsessive-compulsive attitudes, patients with this state of mind are aware that such attention is concentrated and fixed and cannot be transferred, so it is also called mandatory attention.
Among them, attention to weakening and attention to stenosis is the most common. Attention disorders are often accompanied by disturbances of consciousness. Any part of the brain lesions, especially a wide range of lesions, cause damage to attention, a decrease in arousal, a high level of lethargy or awakening, and a state of nervous anxiety, which affects attention. Continuous concentration, schizophrenia and mild dysfunction syndrome in children also have attention deficits.
Diagnosis
Differential diagnosis
Differential diagnosis of attention disorders:
(1) Functional psychosis:
1. Schizophrenia: Initiation in puberty, manifested as uncoordinated intelligence, affection, and intention. Consciousness is clearly dominated by illusory delusions, attention is impaired, mental activity appears to be slow, and attention is paid to the external environment. The power is very poor, but the center is thinking about its inner world, so it seems very clever.
2. Depression: Depressed by low emotions, lack of interest in surrounding things, decreased energy, social withdrawal, and decreased attention.
3. Mania: Influenced by high emotions, self-satisfaction is energetic, interested in all kinds of activities, passive attention to function is hyperactive, this matter is not finished and is attracted to other things, and is transferred to the environment. Give people the impression of an increase in activity.
4. Anxiety (anxiety): can start at any age, more common before the age of 40, often have psychological or physical post-inducence, mental anxiety is the core symptom, accompanied by irritability, attention to concentration difficulties and sound and light Sensitive, often complained of memory loss, is actually the difficulty of reading caused by the inability to concentrate, often accompanied by autonomic dysfunction.
5. Hypochondriasis: The onset of middle-aged disease, many people with slow onset, mainly showing suspected troubles, excessive attention to health, suspected discomfort and suspected concept, and excessive attention to health The focus is on the health of the body, paying special attention to any subtle changes in the body, especially regarding the function of the body parts they suspect. They do everything possible to carry out various tests to confirm their beliefs.
6. Depressive neurosis: Most of the onset of young and middle-aged, pre-existing psychosocial stress, clinically persistent low mood, sleep disorders and physical discomfort, common symptoms: fatigue, Inability to think hard, not pay attention to concentration, memory loss, work efficiency decline, difficulty falling asleep, etc., the course of disease is at least one or more.
7. Neurasthenia: its main performance:
1 debilitating symptoms: mental fatigue, mental retardation, inability to concentrate, memory difficulties, work or study can not last, efficiency is reduced;
2 excitement symptoms;
3 tension headaches;
4 sleep disorders, the course of disease is more than 3 months.
(2) Reactive twilight state: There are major psychosocial stimuli on the onset, the level of expression consciousness is reduced, the scope is narrow, the orientation is incomplete, the expression is nervous and fearful, accompanied by vivid sleepy illusion or dream experience. It is difficult to concentrate, and if you answer questions, you can have impulsiveness and things can't be remembered.
(3) Dementia paralytica: The disease begins with sneak sneak, early symptoms of neurasthenia, headache, dizziness, fatigue, inability to concentrate, memory loss, etc., but not active, can have work ability Signs of decline and personality changes continue to develop symptoms of dementia.
(4) Encephalitis (fncephlitis): a viral infection originating in the brain, with acute onset, sudden high fever, convulsions, headache, vomiting, rapid emergence of disturbances of consciousness and focal neurological symptoms, manifestation of debilitation, drowsiness , sluggish language, understanding difficulties, pay attention to distraction, poor orientation, memory impairment, incontinence and so on.
(5) Childhood hyperactive syndrome: the vast majority of boys, mainly hyperactive, poor academic performance, can not listen quietly in class, small movements, and even interfere with others, may have impulsive behavior, hyperactivity is attention can not After the discovery of the focus, the intelligence is normal, most boys reduce the hyperactivity after puberty, but pay attention to the inability to concentrate and continue to exist.
(6) Infant autism (infanile autisn): mainly in childhood (within 3 years old), mainly showing introversion, speech disorder, compulsive requirements to maintain the same state, etc., in addition to this, the child can return It is characterized by hyperactivity or attention to the transfer of the environment and some strange movements, sometimes the child can suddenly anger or express fear for no reason. Most children have a poor prognosis and cannot live independently or need long-term containment.
(7) Postconcussion syndrome: The concussion is an acute brain dysfunction caused by head trauma. After a concussion, the patient has headache, dizziness, dizziness, nausea, emotional instability, fatigue, and inattention. Insomnia, multiple dreams, excessive sensitivity to sound and light stimulation, the nervous system in addition to possible nystagmus, generally no other positive signs, these symptoms generally fade within 1-2 weeks, there may be prolonged or chronic .
(8) Mental disorder with brain tumor: The mental symptoms of brain tumors are often related to the part where they grow. Even slower tumors often have mental illness, about 37% of brain tumors. Patients can produce confusion, decreased attention, decreased memory, slow response to the surrounding environment, and asymmetry in the symptoms of apathy and partial dysfunction.
(9) alzgeimer disease: usually onset from 50 to 60 years old, insidious onset, clinical features for continuous mental decline, no relief. The accompanying mental symptoms include aphasia, forgetfulness, loss of recognition, poor judgment, loss of general ability, distraction, confusion and concentration, and the development of the disease becomes more and more obvious.
(10) Nental disorder with acquired immune deficiency syndrome: The vast majority of hiv first infected patients do not have clinical symptoms, hiv can directly invade the central nervous system (cvs) causing cns infection. One of them is aids dementia syndrome. The clinical manifestations of insidious onset are weakness, burnout, loss of interest, lack of sexual desire as the first symptom, and later characteristic cognitive impairment, behavioral and motor dysfunction, including near memory impairment. Attention to obstacles, slow speech, social withdrawal, etc., late stage can have obvious dementia, silence and incontinence, and there may be disturbance of consciousness. From the appearance of dementia to death lasted about 4.2 months. At this time, the patient's blood was positive for HIV, and the cerebrospinal fluid was examined for inflammatory changes. Eeg shows extensive warm wave, ct shows atrophy of the cerebral cortex and enlargement of the ventricles.
