Troubles mentaux organiques d'origine toxique

M.-A. Boillat (MD, MSc, Professeur associé à la faculté de biologie et de médecine de l'université de Lausanne)
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Abstract

Solvents are widespread in use and, due to their lipophilic properties, they can interfere with nerve cell function. This explains why they are the main compounds involved in chronic toxic encephalopathy. Whereas acute effects are clearly accepted in the scientific community, there has been some debate on their chronic toxicity. In the 70s, the first studies were published on chronic toxic encephalopathy (CTE) in Scandinavia. In the 80s, an international classification defined four stages of the disease, from organic affective syndrome to dementia. One difficulty in diagnosis is the lack of specificity and the lack of knowledge on the mechanisms involved, particularly the nature of solvents, the doses and the duration of exposure. The syndrome is characterized by mood changes, followed by memory and attention impairment, difficulty in concentration and learning capacity, and in a final stage by generalized deterioration of cortical function. Advanced stages of chronic toxic encephalopathy have a poor prognosis with limited reversibility at best.

有毒来源的器质性精神障碍
溶剂被广泛使用,由于它们的亲脂性,它们可以干扰神经细胞的功能。这就解释了为什么它们是慢性中毒性脑病的主要化合物。虽然急性效应已被科学界明确接受,但对其慢性毒性仍有一些争论。上世纪70年代,斯堪的纳维亚地区首次发表了关于慢性中毒性脑病(CTE)的研究。上世纪80年代,一项国际分类将这种疾病分为四个阶段,从器质性情感综合征到痴呆症。诊断的一个困难是缺乏特异性和对所涉及的机制缺乏了解,特别是溶剂的性质、剂量和暴露时间。该综合征的特征是情绪变化,随后是记忆和注意力障碍,注意力和学习能力困难,最后阶段是皮质功能的全面恶化。晚期慢性中毒性脑病预后差,可逆性有限。
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