title: Cognitive impairment and general anaesthesia - Case report.
abstract: Degeneration of cholinergic receptors causes memory disorders and irreversible impairment in cognitive functions, whose advancement can lead to clinically recognizable Alzheimer's disease (AD). Very often, the first symptoms of AD are mood swings and hence depression should be excluded by differential diagnosis since it can also cause memory disorders and cognitive deficits. Due to the characteristic clinical picture of AD, its diagnosis should not be a problem, except at the very beginning of the disease. Many AD patients are never diagnosed and therefore are not adequately treated in clinical practice. Agents used for general anaesthesia reduce cholinergic transmission, which is manifested by loss of consciousness, pain, voluntary movements and memory. In patients with compromised memory and cognitive functionality, general anaesthesia can postoperatively have an adverse effect on the prognosis of degenerative cerebral disease. A patient is described whose preoperative impaired memory and cognitive functioning deteriorated after general anaesthesia and whose clinical picture reached the extent of AD.
authors.affiliation: Psychiatric Hospital Sveti Ivan, HR- 10090 Zagreb, Croatia. pbsvi@pbsvi.hr
authors.forename: Paola
authors.initials: P
authors.lastname: Presecki
authors.forename: Mate
authors.initials: M
authors.lastname: Mihanović
authors.forename: Ninoslav
authors.initials: N
authors.lastname: Mimica
mesh_terms: D000544:Alzheimer Disease / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology; D000768:Anesthesia, General / Q000009:adverse effects*; D001928:Brain Diseases, Metabolic / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology; D003937:Diagnosis, Differential; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests