![]() ![]() Despite these discoveries, many elements in the pathogenesis remain to be confirmed. This abundant secretion of corticosteroids impairs normal activity of these structures and induces hippocampal atrophy, as well as defects in neural activity. The amygdala and the hippocampus, the two most important structures that mediate arousal and memory, respectively, possess a very large number of glucocorticoid receptors. Namely, excess levels of glucocorticoids, the main stress hormones, have been identified in this subset of patients and their activity on the central nervous system and structures responsible for learning and memory have been well-documented. Additionally, a subtype of dissociative amnesia, known as dissociative fugue, is a term that describes intentional avoidance from harmful stimuli and further indicates that amnesia is most likely a protective response. In the setting of extensive emotional trauma, dissociative amnesia is considered as a mechanism of protection and various biological events have been described. Studies have confirmed that functional brain imaging such as PET scanning shows reduced glucose uptake in various regions, such as the inferolateral prefrontal cortex, which is known to be the site where retrieval of autobiographical memories occurs. EEG is necessary to perform in order to rule out seizures. Blood and urine toxicology tests should be done, together with imaging studies including CT or MRI to exclude trauma. Prior physical trauma to the temporal lobe or the hippocampus, seizures and drug abuse should be included in the differential diagnosis. Before making the diagnosis, other organic conditions that present with similar complaints need to be excluded. It is important to establish the absence of anterograde amnesia, which is rarely present in patients with dissociative amnesia. Patient history is the single most important part of the diagnostic workup, since a careful and gentle approach to the patient may reveal key information regarding memory loss and its onset. Unspecified Dissociative States DDNOS is a category of disorders that manifest with dissociative symptoms but fail to meet the diagnostic criteria for any of the dissociative syndromes described. Other forms of DDNOS include possession and trance states, Ganser's syndrome, derealization unaccompanied by depersonalization, dissociated states in people who have undergone intense coercive persuasion (e.g., brainwashing, kidnapping), and loss of consciousness ![]() They may provide approximate inaccurate answers to questions (e.g., “2 plus 2 equals 5”) as in Ganser syndrome. They may provide approximate inaccurate answers to questions (e.g., "2 plus 2 equals 5") as in Ganser syndrome. We report a single case of "chameleon" syndrome that challenges the current international criteria for somatoform disorders, dissociative amnesia, and Ganser syndrome. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |