What distinguishes them from amnesic disorders is that amnesia may be absent or not so pronounced as to play a leading role. But the distortion of memory, or paramnesia, will be necessary, they simply can not be overlooked in such cases,and the colors of the picture of the disease will be due to them. There are three of these syndromes:
1) Korsakoff’s syndrome;
2) Confabulation;
3) Violent memory syndrome.
Korsakov syndrome was first described by S. S. Korsakov [51] in 1887. It is interesting because it intertwines both productive symptoms (paramnesia) and negative (amnesia). Its leading, mandatory, or obligate symptoms:
- Fixation amnesia, that is, the events of the current moment and recent (days, months, last year) time pass through this sieve without being delayed. Here are the events of youth, youth and childhood — this is a different conversation, up to the name of the first love and the circumstances of the first drink. Everything, up to the beginning of the disease itself. Next — a blank sheet, on which memory and displays the bizarre patterns of paramnesias. Fixation amnesia can be so pronounced that it is almost impossible to teach the patient something new, and moving to a new place of residence is a disaster (going out alone on the street, he will get lost, most likely, go to the old address and perhaps try to drive out new residents). Such amnesic disorientation can concern both the place and time, as well as basic professional and everyday skills. Therefore, it is better for relatives to take care of washing, cleaning and, especially, cooking dinner — they will be safer.
— To many cases of paramnesia.
In the case of Korsakovsky syndrome, they are as follows.
- Confabulations (when gaps in memory are filled with events that never occurred in the patient’s life). In the vast majority of cases, these are substitute confabulations (that is, not very far removed from everyday mundane reality): yesterday I sat with friends in a restaurant, Yes, right after work; a week ago I went hunting, shot two boars and one huntsman, but Shh! Less often they are fantastic (I was on a special mission, thwarted the plans of the world’s financial elite for a carefree holiday: I poured tar into honey, poured sugar into beer, clofelin into vodka and ice into a swimming pool, barely left alive).
- Pseudoreminescence (when a gap in the patient’s memory is replaced by a piece of the mosaic from his own life, only from the time when the disease itself did not exist).
- Cryptomnesia (when the patient borrows events from books, movies, TV shows — from everywhere-to fill in gaps in memory). Therefore, it is better to leave something harmless out of literature. No, “Hansel and Gretel” and “Baby and Carlson” are also better put out of harm’s way. It is better not to doubt the personal authorship of famous poems, songs, and scientific works — neither you nor the patent office can explain anything to him. And Windows is also all his credit, no matter what bill gates thinks.
— Anosognosia (a-negation, from the Greek onosis-disease, gnosis-cognition, knowledge), that is, a complete lack of understanding and denial of the fact of the disease and related problems. And here it will be rough, Terry. “Who’s sick? Am I ill? Yes, I’m healthy, like this… like his … horse of Macedon…Ah, Imbecile, in! Yes, I’ll get a job tomorrow at least-immediately as a Director! Wait, I already work there…»
Optional, or additional, optional, symptoms can be affective disorders: anxiety or complacency, carelessness or confusion, euphoria, emotional lability, when the mood jumps from one pole to the other several times a day and changes from any trifle. The patient may be either sedentary, hypodynamic, or, on the contrary, fussy and restless — depending on what kind of affect prevails.
According to the dynamics of Korsakov syndrome can be:
- progressive (when the severity of symptoms increases);
- regressing (when things are on the mend) and
- inpatient (when the symptoms in their severity and severity do not change for many years in either direction).
The cause of Korsakoff’s syndrome — brain damage: the toxic effect of alcohol in Korsakov’s psychosis, other intoxications, infections, trauma, tumor, vascular damage (in stroke and atherosclerosis, for example), atrophic processes in the cerebral cortex.
Confabulation. What is remarkable is that there is no amnesia or clouded consciousness in this syndrome. But confabulation — as much as, and no! Incredible, fabulous, fantastic (which, in fact, should be fantastic confabulations). There are dinners with the President, and Affairs with the wives of Ministers, and escapes from their angry spouses, stuck horns in doorways and goading their loyal nookers, and escape from the country in a diplomatic parcel with cannabis (“just sent to the Netherlands”). For those of confabulation, in addition to the fantastic typical variability of the plot: only yesterday savoured the delights of Ministerial wives and zaboristoe diplomatic mail, and today switched to the details of the abduction of American spy satellites directly from geostationary orbit with a view to push the information home intelligence, and valuable scrap — friendly Madagascar. Another distinctive feature of confabulation is the patient’s desire to prove that this is exactly what happened. “Don’t you believe it? Yes, there, you see-a spoon! Yes, Yes, Malagasy friends cast from the same satellite, as a souvenir.”
Confabulation can develop as an independent syndrome or be a stage in the transition of delirium to Korsakovsky psychosis. If this is an independent syndrome, then the way out of the painful state is usually critical, that is, once — and there is an “Epiphany”. It is usually found in mental diseases caused by damage to the blood vessels of the brain or with severe infections, severe somatic diseases and — quite often-with intoxication.
Violent memory syndrome. The memories are real, they really took place in the life of this particular person. It would seem — what is abnormal here? The abnormal thing here is the WAY they come. Not purposefully (I wanted to-I remembered), not accidentally, obeying a chain of free associations (“they Write that a dog … a lapdog… a bitch … damn! My mother-in-law’s birthday!”). Violent memories invade your mind without invitation, like College students in a Dorm who find out that you’ve been brought three bags of food and one case of vodka from home. They fill in everything-up to the point of not being able to assimilate anything else from current events, and later-leaving no chance to remember if anything was happening at that moment: the memories themselves were, but what was I doing then and where was I?
This syndrome occurs when the left parietal-temporal region of the brain is affected.
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