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WHAT: Organic brain syndrome. Organic Brain Syndrome: either a long term deterioration of intellectual function and memory (dementia) or a short term disturbance of orientation, judgement, or consciousness (delirium). Both may be marked by illusions, hallucinations, delusions, or disturbances of perceptions, mood, behavior, cognitive capacity, or personality. WHY: Delirium can occur with rheumatic fever or cerebral vasculitis. Both delirium and dementia can occur in systemic lupus erythematosus, and rarely also in mixed connective tissue disease. HOW: Ten or more incorrect responses to the following 30 questions usually means an organic impairment exists. 1) What day of the week is this? 15) The opposite of fast is slow. 2) What month? The opposite of up is? 3) What day of the month? 16) The opposite of large is? 4) What year? 17) The opposite of hard is? 5) What place is this? 18) An orange and a banana are 6) Repeat these numbers 8 7 2. both fruits. A penny and a 7) Say them backwards. dime are both? 8) Repeat these numbers 6 3 7 1. 19) Red and blue are both? 9) Listen to these numbers 6 9 4. 20) What are those words I asked Count 1 through 10 out loud, you to remember? (HAT) then repeat 6 9 4. (Help if 21) (CAR) needed; then use 5 7 3.) 22) (TREE) 10) Listen to these numbers 8 1 23) (TWENTY-SIX) 4 3. Count 1 through 10 out 24) 100 minus 7 is? loud; then repeat 8 1 4 3. 25) Minus 7 is? 11) Beginning with Sunday, say the 26) Minus 7 is? days of the week backwards. 27) Minus 7 is? 12) 9 + 3 is? 28) Minus 7 is? 13) Add 6 (to answer of 12). 29) Minus 7 is? 14) Take away 5 (from answer of 18). 30) Minus 7 is? Repeat these words after me and remember them. I will ask for them later. HAT, CAR, TREE, TWENTY-SIX. REFS: 1) \'Organic Brain Syndromes\'. In Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. (DSM III). Washington, D.C.: American Psychiatric Association, 1980. 2) West, ND: \'Organic Brain Syndromes\'. In Psychiatry in Primary Care Medicine (Ch. 2). Chicago: Year Book Medical Publishers, Inc., 1979. 3) Sharp, GC: \'Mixed Connective Tissue Disease and Overlap Syndromes\'. In Textbook of Rheumatology (Ch. 71). Philadelphia: W.B. Saunders Co., 1981. 4) Bennet, RM and Spargo, BH: Neuropsychiatric problems in mixed connective tissue disease. Am J Med 65(6), December 1978, pp. 955-62. DN193071. 5) Jacobs, et al.: Screening for organic mental syndromes in the medically ill. Ann Intern Med 86(1), January 1977, pp. 40-46. DN19308-9.
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