current location：Home > Anxiety disorder > Multiple recurrences of bipolar affective disorder cause brain damage, prompt surgery is the key to treatment text

Multiple recurrences of bipolar affective disorder cause brain damage, prompt surgery is the key to treatment

Time：2023-02-02 00:19:30 source：psychiatricethics.com author：Anxiety disorder Read：335次

Multiple recurrences of bipolar affective disorder cause brain damage, prompt surgery is the key to treatment

Original article, misappropriation must be investigated bipolar disorder is prone to recurrence. According to outpatient statistics, nearly 90% of patients will have at least 2-3 attacks, and they must take lifelong medication to prevent irreversible brain damage. Bipolar disorder is like chronic diseases such as high blood pressure and diabetes. If long-term regular medication is used, most patients can work and live as normal. As the name suggests, bipolar disorder has mania and depression. It is a bipolar disorder. 70% of patients with bipolar disorder often have depressive symptoms in the early stage. The other party has bipolar disorder. Especially in the stage of hypomania, the patient is constantly thinking, his speech is sonorous, his eyes are piercing, and the whole person is in a state of excitement. At this time, if no medication is used to regulate emotions, the prefrontal lobe of the brain and the physical area of the palm can be balanced. It may worsen to hypermanic, manic stage.

12-year-old bipolar patient with uncontrolled drug withdrawal and relapse

A 40-year-old female Cui, bipolar, was admitted to the outpatient clinic. A history of emotional disorder for 12 years. During a manic episode, he suddenly pointed at strangers while walking on the road and yelled at strangers, knocked down a billboard at the entrance of a shopping mall, and scuffled with the security guard. Finally, he was forced to be admitted to the hospital by the police for treatment. Depressed and meaningless to live, I washed my face with tears all day, and once ate a whole bottle of olanzapine in the middle of the night. The family was helpless about this. During the 12 years of illness, the patient was hospitalized for nearly 10 times, but every time he was discharged from the hospital, he secretly stopped the medication, which led to the recurrence of symptoms, which caused the family to jump around and turn around. Why does the onset of bipolar disorder cause uncontrolled behavior? This is because the symptoms of mania are related to the overactivation of the amygdala, which is responsible for the source of fear in the brain, resulting in disturbances in the patient's emotional perception and response; Balance problems, coupled with poor impulse control in the frontal lobe of the eyes, can easily lead to doing things without considering the consequences, and patients often do things that are obviously contrary to common sense.

Relapsing symptoms are becoming more and more difficult to treat after repeated drug withdrawals

90% of patients with bipolar disorder will have repeated attacks, and most patients will have at least 2-3 attacks , Only 10% of people have only one attack, so most patients need lifelong medication for prevention. However, for bipolar disorder drugs, if a large dose is taken orally, sometimes more than ten pills are swallowed a day. In addition, the drugs will cause side effects such as involuntary muscle movements. After taking the drugs, the face may become stiff and unnatural, which may cause some patients to not comply with the medication. , leading to disease recurrence. What is worrying is that once bipolar disorder occurs acutely, not only the symptoms are severe, but the difficulty of drug control will also increase significantly. Since nearly 50% of the bipolar patients with recurrent bipolar disorder do not take medication regularly, those with poor medication compliance may wish to choose surgical treatment to control symptoms, reduce medication dose, restore insight, and improve Medication compliance. At the end of 2021, the patient Cui Mou underwent surgical treatment in the functional neurology department of our hospital. After the operation, she was like a different person. The irritable temper, impulsive violence, negative world-weariness and other mental symptoms that once troubled the patient and her family disappeared, and Cui Mou changed. Must have a mild temper, be reasonable, have their own views on the disease, realize that the disease requires long-term stable treatment, and be willing to cooperate with medication and rehabilitation. Half a year after the operation, Cui took the medicine on time and was occasionally depressed, but he could get out of the emotional black hole under the guidance of his family and maintain a good state of mind.

Principles of psychosurgical treatment options

Modern scientific research has found that the medial limbic circuit, cingulate gyrus, and amygdala are closely related to the pathogenesis of psychosis, which we call It is 3+x, and "3" represents three classic psychosurgery targets, namely cingulate gyrus, internal capsule forelimb, and amygdala, which are the three most important nodes in emotion and emotion regulation loops. Nucleus theory, transmitter regulation theory in the pathogenesis of psychosis, receptor hyperfunction theory, as well as previous clinical practice, selective partial damage and blocking can effectively control symptoms; "X" represents the patient's core symptoms, and then select Other corresponding targets in order to achieve the best efficacy. After surgery, it can help patients: 1. The mental symptoms that are difficult to control by drugs can be controlled or eliminated; 2. Reduce drug use and improve drug efficacy, thereby reducing drug side effects, and some patients may discontinue the drug; Return to society and complete normal social functions, including study, life, social interaction, work, etc.

To our readers:

Hello, I am Dr. Wu Jingwen, and I would like to thank you all for reading my article. If you have a disease and consult me, you can contact me through the platform "private message". You can also leave a message under the article, and I will answer your questions as soon as possible.