View source for Metabolic and toxic encephalopathies and neuropathies

Metabolic and toxic encephalopathies and neuropathies are secondary, acquired disorders that arise as a result of changes in the internal environment of the organism, for example as a result of some internal diseases ("metabolic encephalopathies").

== Anoxic ischemic encephalopathy ==
Etiology: [[hypotension]], cardiopulmonary insufficiency

Causes: [[myocardial infarction]], cardiac arrest, [[hemorrhagic shock]], [[asphyxiation]], [[CO intoxication]]

* hypoxia mostly affects the cortex and subcortical structures

Clinical picture:
* [[hypoxia]] → restlessness, [[anxiety]], disorders of attention and motor coordination
* [[anoxia]] → loss of consciousness, generalized [[convulsions]]e (tonic)
* prolonged anoxia → [[coma]] ([[mydriasis]], extinguished [[photoreaction]]) to [[brain death]]

Treatment: [[nootropics]]


''Posthypoxic (postanoxic) syndrome'': persistent coma or other [[disorders of consciousness]], [[apalic syndrome]], [[dementia]], [[parkinsonian syndrome]], [[cerebellar syndrome]], [[ choreoathetosis]], [[Korsak amnestic syndrome]], intentional or action [[myoclonus]]<ref name="Ambler">{{Citation
|type = book
|corporation =
|surname1 = Ambler
|name1 = Zdeněk
|surname2 =
|name2 =
|surname3 =
|name3 =
|collective =
|title = Fundamentals of Neurology
|issue = 6
|place = Prague
|publisher = Galen
|year = 2006
|pages = 253
|edition =
|bundle =
|isbn = 80-7262-433-4
}}</ref>

== Hypercapnic encephalopathy ==
Etiology: increased partial pressure of CO<sub>2</sub> → chronic [[emphysema]], [[respiratory insufficiency]], chronic [[respiratory acidosis]]

Clinical picture: [[headaches]], [[Consciousness disorders|somnolence]], psychomotor retardation, [[asterixis]], possibly. [[confusion]] to coma

== Hypoglycemic encephalopathy ==
Etiology: excessive dose or increased secretion of [[insulin]]u

Clinical picture: nervousness, headaches, [[palpitations]], anxiety, [[sweating]], [[tremors]], motor restlessness, [[muscle spasms]], myoclonus, [[hyperreflexia]], ev. confusion to coma, [[epileptiform convulsions]], focal neurological symptoms (convulsions, paresis)

Treatment: [[glucose]] i.v.

== Hyperglycemic coma ==
Etiology: [[ketoacidosis]], [[hyperosmolality]], [[hypoxemia]]

== Hepatic encephalopathy ==
Etiology: [[chronic liver insufficiency]] with portocaval shunt

Clinical picture: confusion, convulsions, asterixis, metabolic tremor, [[spastic pyramidal phenomena]], [[ataxia]] standing and walking, choreoathetosis

Treatment: [[lactulose]]

== Uremic encephalopathy ==
Clinical picture: fatigue, [[apathy]], increased irritability, confusion, muscle twitches to myoclonus, metabolic tremor, asterixis, convulsions, epilethiform seizures

== Endocrine encephalopathy ==
Causes:
* administration of [[ACTH]] or [[corticosteroids|corticosteroids]]

→ psychotic clinical picture

* [[hypothyroidism]]

→ confusion, mania or depression, muscle weakness

== Diabetic polyneuropathy ==
Etiology: [[chronic hyperglycemia]]

== Alcoholic polyneuropathy ==
Etiology: deficiency, nutritional and vitamin deficiency (especially [[thiamin]]u), direct toxic effect of alcohol on peripheral nerves

Clinical picture: symmetrical mixed sensory and motor involvement acral on the lower limbs, [[dysautonomia]], [[hyperhidrosis]], [[axonal type neuropathy]]

Treatment: abstinence, adequate nutrition, vitamins B1 and [[Vitamin B12|B12]]

== Toxic polyneuropathies ==
Etiology: [[organophosphates]], [[carbon disulfide]], [[lead]], [[mercury]], [[hexacarbons]], [[isoniazid]] (therefore administer [[pyridoxine]] as a preventive measure), [[cytostatics]] ([[vincristine]] - therefore we administer with [[glutamic acid|glutamic acid]]), [[amiodarone]], [[statins]]



== Links ==
=== Related Articles ===
* [[Toxoinfectious encephalopathy]]
* [[Encephalopathy]]
* [[Hyperglycemic Coma]]
* [[Heavy metal poisoning]]
* [[Alcohol intoxication]]
* [[Anoxia]]

=== References ===
<references />

=== Literature ===
* {{Citation
|type = book
|corporation =
|surname1 = Ambler
|name1 = Zdeněk
|surname2 =
|name2 =
|surname3 =
|name3 =
|collective =
|title = Fundamentals of Neurology
|issue = 6
|place = Prague
|publisher = Galen
|year = 2006
|pages = 253-254
|edition =
|bundle =
|isbn = 80-7262-433-4
}}

[[Category:Neurology]]

Done by: Eisa Jbara