Konfabulez – the psychopathological syndrome which is shown flow of false memoirs which form one or several stories with consecutive events and the finished contents. Patients in details describe actions, appropriate a role of the main character making noble and courageous acts. The syndrome is characteristic of infectious and intoksikatsionny psychoses, can arise at schizophrenia, a senile parafreniya, after ChMT. Konfabulez comes to light by method of a conversation, observation. For the purpose of differential diagnostics tool and psychological inspection is carried out. Treatment is symptomatic medicamentous, it is carried out within therapy of the main pathology.
The term "konfabulez" is formed by a combination of words Latin and Greek, meaning "to talk, tell" and "disease". This frustration concerns to group of paramnestichesky syndromes – memory violations at which to the forefront there are distortions of memoirs, but not amnesia. Konfabulez proceeds against the background of clear consciousness, there are no considerable disorders of memory, violation of spatial and temporary orientation. Prevalence is higher among patients of mature and advanced age. At children and teenagers cases of emergence are extremely rare, accompany some forms of schizophrenia. Reliable epidemiological data are absent as the uniform concept of an origin of a syndrome is not developed.
Reasons of a konfabulez
Konfabulez is directly connected with mnestichesky frustration and the previous consciousness obscuring period. Serious somatic illnesses, psychoses exogenous and endogenous (more rare) than an origin become factors of development of a syndrome. Immediate causes of a konfabulez continue to be investigated. Today several etiologichesky groups are allocated:
- Infectious diseases. The syndrome is formed at parasitic typhus, malaria, primary and secondary encephalitis. Flow of fantasy memoirs is noted after the fever period.
- Craniocereberal injuries. Paramnesias arise at a regreduated stage, after the sharp period more often. Konfabulyation are characteristic of violations of craniocereberal blood circulation.
- Intoxications. The psychotic state develops as a result of impact on a brain of toxic substances. Intoxication is observed at abuse of alcohol, psychotropic medicines.
- Schizophrenia. Konfabulez is shown in the context of parafrenny nonsense. Besides false memoirs with the nature of unwinding konfabulyation with the ideas of prosecution, influence, greatness are noted.
- Senile psychosis. The Konfabulyatorny state is the stable period of frustration replacing sharp hallucinatory and crazy syndromes. "Memories" of fantastic events in the past – about feats, merits, improbable meetings prevail.
Konfabulez carry to the transitional (intermediate) syndromes caused by reversible organic changes. The pathogenesis is up to the end not studied. False memoirs are formed as result of pathological processes in certain structures of a brain. Presumably, injuries of a hippocampus – department of the brain which is responsible for storage and reproduction of information of long-term memory, formation of memoirs can be the cornerstone of a syndrome. The theory about the leading role of pathologies of blood circulation in back brain arteries which supply with blood the lower sites of temporal shares, average occipital shares of a cerebral cortex, and also a trunk and a cerebellum is put forward.
Symptoms of a konfabulez
Symptoms are developed at clear consciousness, the kept orientation in space and time, but the broken critical relation to own state. The patient composes the taken place events and own actions, believes in their reality. As a rule, scenarios differ in incredibility, improbability. The story-teller acts as the main character, makes the acts causing approval and admiration of people around: saves the child or the old man from death, prevents accident, helps more persons of no character, is engaged in development of valuable drugs, influences decisions of politicians, celebrities. In the story of the patient it is detailed, consecutive, describes the events in detail that makes its history similar to reality.
The emotional condition of the patient during the story remains equal or becomes a little raised. In the presence of hallucinatory and crazy symptomatology euphoria can develop. At sharp symptomatic psychoses it is formed unexpectedly and through a certain time interval suddenly stops. After an exit from psychosis of the patient remembers contents of the story and it is capable to treat critically him that confirms safety of mental abilities. At paranoid schizophrenia and senile psychosis the extensive psychopathological symptomatology therefore konfabulyation stop is added to manifestations of a konfabulez, but the patient remains noncritical.
In view of the fact that is the passing syndrome, development of complications does not happen. In the absence of treatment of the main disease – an infection, intoxication, schizophrenia, senile psychosis, a craniocereberal trauma – is noted the somatic and psychopathological consequences reducing household and social adaptation of the patient.
Diagnostics is based on clinical inspection, is carried out by the psychiatrist and the neurologist. Tool and psychodiagnostic procedures are in addition performed. A task of experts – not only to define existence of the false, invented memoirs, but also to establish their reason, to differentiate with a korsakovsky syndrome. Comprehensive examination includes:
- Diagnostic conversation. Collecting the anamnesis is made in the presence of the relatives of the patient capable to confirm or disprove the validity of his answers. During the poll the doctor finds out the reason of a konfabulez, specifies character and degree of expressiveness of violations of memory, estimates chronological and spatial orientation, existence of crazy and hallucinatory symptomatology. Unlike a konfabulez, at a korsakovsky syndrome amnesia and an existential disorientation is found.
- Neurologic inspection. Allows to differentiate consequences of ChMT, heavy infections and intoxications. The doctor studies sensitivity, safety of reflexes, movement skills, a condition of a muscular tone.
- Tool methods. For assessment of a condition of TsNS and identification of the reasons of a konfabulez EEG, KT and MRT of a brain, UZDG of vessels of a brain is appointed. Results give the chance to confirm or disprove organic pathology as the reason of konfabulyation.
- Psychodiagnostics. Patopsikhologichesky inspection is necessary for detection of schizophrenia, symptoms of psychosis. Features of mnestichesky processes are investigated, existence of high-quality changes of thinking, decrease in intellectual functions is defined.
Treatment of a konfabulez
Specific therapy of a konfabulez is not carried out. Treatment of a syndrome is performed taking into account its etiology, that is a provocative disease – intoxication, an infection, senile psychosis, schizophrenia, ChMT consequences. Symptomatic therapy is selected psychiatrists and neurologists individually according to a clinical picture. At the increased excitement, psychopathological symptomatology, behavioural and emotional frustration neuroleptics, anksiolitik are appointed. At organic defeats of TsNS nootropa, vasoprotectives are applied to improvement of blood circulation of a brain and metabolic processes in nervous cages.
Forecast and prevention
The forecast of a konfabulez depends on features of a course of the main pathology. At ChMT consequences, intoxications, infections tranzitorny symptomatic psychosis is observed. All its symptoms disappear in the course of recovery of the patient. At senile psychosis and schizophrenia can repeatedly develop in the stable periods of a disease. Performing specific prevention is impossible. To prevent emergence of a konfabulez, it is necessary to minimize probability of a provocative disease. For preservation of physical and mental health it is recommended to lead a healthy lifestyle: to refuse alcohol intake, smoking, it is balanced to eat, give to an organism regular physical and intellectual activity, to allocate sufficient time for a dream and rest.