1/2. The neurology of alcoholic denial: implications for assessment and treatment.Alcohol has neurotoxic effects that frequently result in significant sensorimotor and cognitive deficits. These cognitive deficits may have profound implications for the behaviour and treatment of patients who abuse alcohol. In particular, the deficits in executive cognition that are typical of alcoholic dementia result in difficulties with planning, insight and impulse control. These deficits are frequently misinterpreted as alcoholic denial and are therefore assumed to have a psychodynamic basis. This paper reviews the neurological substrates for insight and self-monitoring and discusses a possible pathophysiology for a subgroup of alcoholic patients who exhibit alcoholic denial. Implications of this model for the evaluation and treatment of alcoholic patients are discussed.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/2. Wernicke-korsakoff syndrome following attempted hanging.The case of an alcoholic man is reported who survived a suicidal hanging attempt, and subsequently suffered of amnesia, dementia, apathy and behavioural abnormalities. A clinical diagnosis of hypoxic brain damage was made, but upon autopsy six years later, extensive pseudosystematic thalamic degeneration and mammillary body atrophy were found, indicating a status post wernicke encephalopathy. Precipitation of the disease is attributed to the synergetic effect of cerebral hypoxia/ischemia and thiamine deficiency.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |