|
Clouding of consciousness, also known as brain fog or mental fog, is a term used in conventional medicine denoting an abnormality in the regulation of the overall level of consciousness that is mild and less severe than a delirium. The sufferer experiences a subjective sensation of mental clouding described as feeling "foggy". ==Background== The term ''clouding of consciousness'' has always denoted the main pathogenetic feature of delirium since Greiner first pioneered the term (Verdunkelung des Bewusstseins) in 1817. The Diagnostic and Statistical Manual of Mental Disorders (DSM) has historically used the term in its definition of delirium. Recently the DSM has replaced “clouding” with “disturbance” but it is still the same thing. Confusingly, however, there appears to be a trend among many doctors to now redefine clouding of consciousness to be less severe than delirium on a spectrum of abnormal consciousness.〔 In this case, it can be said that clouding of consciousness is synonymous with ''subsyndromal delirium''. Subsyndromal delirium differs from normal delirium by being overall less severe, lacking acuteness in onset and duration, having a relatively stable sleep-wake cycle, and having relatively stable motor alterations. The significant clinical features of subsyndromal delirium are inattention, thought process abnormalities, comprehension abnormalities, and language abnormalities.〔 The full clinical manifestations of delirium may never be reached.〔 Subsyndromal patients are likely to survive but require institutionalization〔 or have a decreased post-discharge level of functional independence.〔 It is featured in such conditions as ''minimal hepatic encephalopathy'' (also known as ''subclinical hepatic encephalopathy'' or ''latent hepatic encephalopathy''), ''subclinical Wernicke's encephalopathy'', ''candidiasis'', Lyme disease, anaphylaxis, and intestinal ''tapeworms''. The condition whereby intestinal faecal toxins bypass the liver poisoning the brain causing clouding of consciousness used to be referred to as "autointoxication" but is now referred to as "hepatic encephalopathy". Minimal hepatic encephalopathy reduces quality of life by impairing work activities, social interactions, and driving, but it does not affect basic daily life activities such as dressing, personal hygiene, eating, shopping, answering the phone, or taking public transportation.〔 Patients with MHE may even exhibit normal cognitive performances, but overall productivity may suffer from inattentiveness and fatigue secondary to attention abnormalities.〔 Conventional doctors understudy and neglect subsyndromal delirium because they "expect" delirium to be severe and they prefer to dedicate their medical resources to managing the more immediate "life-threatening" problems. They have a tendency to "psychologize" it and misdiagnose it as depression or apathy.〔 In fact, most clinicians believe that minimal hepatic encephalopathy is "irrelevant" in spite of some evidence indicating that the diagnosis may be important.〔 In clinical practice there is no standard test that is exclusive and specific; therefore, the diagnosis depends on the subjective impression of the physician.〔 The DSM-IV-TR instructs clinicians to code subsyndromal delirium presentations under the miscellaneous category of "cognitive disorder not otherwise specified". 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Clouding of consciousness」の詳細全文を読む スポンサード リンク
|