Амнезия: этиология, классификация и лечение

В жизни каждого человека память имеет большое значение. Память как высшая психическая функция характеризуется отражением действительности и ретенцией событий. Именно память связывает настоящее время и прошлое человека, а также предоставляет возможность участвовать в познавательных процессах и обучаться. Наличие прогрессирующих патологических процессов в организме подвергает различным расстройствам функции памяти. Нарушения при этом проявляются в самых разнообразных формах. Среди наиболее часто встречаемых патологий памяти выделяют амнезию.

Что такое амнезия и поддается ли заболевание лечению? В мировой клинической практике этиология амнезии до конца не изучена, но существует достаточное количество фактов, благодаря которым существуют ответы на подобные вопросы.

Этиология и клинические проявления

Амнезия – это психическое расстройство функции памяти, характеризующееся утратой ретенции и способности актуализировать усвоенную ранее информацию, содержание прошлых событий и невозможность фиксировать происходящее. Состояние сопровождается поведенческими отклонениями, аномальным восприятием происходящих вокруг событий, нарушениями в интеллектуальной сфере и резким снижением мозговой активности.

На качественное функционирование процесса памяти оказывает воздействие довольно большое количество факторов:

  • Амнезияиндивидуальные особенности мозга и психического состояния;
  • концентрации внимания и установка;
  • применение мнемотехнических методик;
  • важность принятия информации.

Патология имеет экзогенный или эндогенный характер возникновения. К эндогенным причинам возникновения амнезии относят:

  1. Дисфункции и отклонения центральной нервной системы.
  2. Аномальное мозговое кровоснабжение.
  3. Генетическая предрасположенность.
  4. Гипоксия – пониженный уровень содержания кислорода в организме.
  5. Болезнь Альцгеймера.
  6. Обменные отклонения в тканях мозга.
  7. Нарушения обмена сложных липидов и аминокислот.
  8. Эндокринные дисфункции.
  9. Тяжелые инфекционные патологии.
  10. Нарушения в психической деятельности.

К экзогенным причинам возникновения амнезии относят:

  1. Наркотическую зависимость.
  2. Травмы головного мозга.
  3. Интоксикации токсическими веществами.
  4. Побочные эффекты от приема седативных или снотворных медикаментов.

Существуют случаи, когда может присутствовать несколько механизмов нарушений памяти. Патологии, способствующие снижение памяти:

  • Снимок участков мозгазлокачественные опухоли;
  • почечная недостаточность;
  • энцефалит;
  • менингит;
  • инсульт;
  • депрессия;
  • энцефалопатия.

Изучением патологии занимаются психотерапевты и медицинские психологи, а также психиатры. Однако существуют случаи сотрудничества с наркологами, неврологами и специалистами иных медицинских сфер.

Расстройства, связанные с потерей памяти, имеют несколько проявлений:

  1. Ухудшение способности запоминать новую информацию.
  2. Невозможность воспроизвести воспоминания из прошлого.
  3. Утрата воспоминаний о самом себе.

Одним из главных симптомов амнезии является невозможность воспроизвести прошедшие события и различную информацию.

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Виды и типы патологии

Рассматриваемая патология имеет сложную специфическую систематизацию, обусловленную несколькими критериями. Амнезия подразделяется на несколько видов.

Виды амнезии следующие:

  • По отношению к временному отрезку:

    • Стирать рисунокпостгипнотическая;
    • конградная;
    • ретроантероградная;
    • перфорационная;
    • репродукционная;
    • антероретроградная;
    • инфантильная.
  • По динамике развития амнезии:

    • прогрессирующая;
    • ретардированная;
    • регрессирующая.
  • По механизму развития:

    • психогенная;
    • истерическая;
    • сенсорно-моторная;
    • травматическая;
    • цифровая.

Существуют и типы амнезии, которые специалисты выделяют и относят к смешанной подгруппе. Болезнь подразделяют на следующие типовые подгруппы:

  • ПазлПолная или частичная амнезия. Утрата воспоминаний в полном объеме или незначительной части;
  • Легкая. Незначительная потеря памяти, обусловленная помутнением сознания или возникшая при легких черепно-мозговых травмах;
  • Внезапная. Характеризуется как внезапная потеря памяти и касается лишь одного момента, возникает ввиду травм или интоксикации организма;
  • Резкая. Мгновенная потеря памяти, чаще всего кратковременная;
  • Кратковременная амнезия. Потеря памяти на несколько секунд или минут;
  • Экспериментальная. Нарушение памяти в условиях эксперимента под влиянием гипоксии головного мозга или введения психотропных медикаментов.

Изучение рассматриваемой патологии на практике показало, что не всегда можно с соответствующей правильностью отнести наблюдаемый случай к тому или другому виду амнезии. Кроме того, мониторинг состояния пациентов свидетельствует о том, что между видами и типами патологии не существует резких границ.

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Классификация по отношению к временному отрезку

Классификация заболевания подразделяется на семь видов амнезий.

Конградная амнезия — это патологическое состояние, характеризующееся отсутствием ретенции событий, происходивших вокруг пациента, а также о нем самом в тот временной отрезок, когда пациент был в состоянии нарушения сознания. Этот вид заболевания чаще встречается в следующих случаях:

  • Девушка с мужчинойглубокого оглушения;
  • тотального отсутствия реакций на внешние раздражения;
  • некоторых формах делирия;
  • аменции;
  • сумеречного состояния сознания.

Этот вид патологии может сохраняться на постоянной основе. Для пациента не представляется возможным воспроизвести в своем сознание прошлые события.

Антероретроградная амнезия характеризуется обструкцией эйфории энграмм (воспроизведение) имеющихся в памяти различных сведений, имен, важных дат, формулировок и событий которые происходили до и после патологического воздействия. Нужная для воспроизведения информация вспоминается значительно позже.

Эта форма расстройства обусловлена дисфункцией медиальных сегментов височной доли, которые включены в круг Папеца. Основной причиной является – изменения, локализующиеся в коре и подкорковых структурах головного мозга. Встречается при тяжелых поражениях головного мозга, кровоизлияниях в мозг и коме.

Ретроантероградная амнезия характеризуется как антероретроградная. Патология этого вида охватывает более или менее длительный временной период нарушения памяти до и после, например, травм головы.

Перфорационная амнезия — это состояние, характеризующееся утратой памяти на отдельную часть произошедших событий, появляющаяся непосредственно после сильнейшего алкогольного опьянения. Пациент, страдающий от алкогольной зависимости в состоянии пересказать события, происходившие во время приема алкоголя, однако, вспомнить чем завершилось мероприятие, не представляется возможным. Перфорационный вид патологии обусловлен симптомом эксплицированного алкоголизма.

Женщина с фотоПостгипнотическая потеря памяти — это отсутствие возможности воспроизвести в памяти реально произошедшие события, имевшие место в момент нахождения человека в измененном состоянии сознания. Патология считается постгипнотическим внушением, которое целенаправленно достигается гипнотизером при помощи умышленного внушения субъекту конкретной информации.

Субъект подверженный данному типу патологии, неспособен самостоятельно воспроизвести последовательность событий. Однако по условной договоренности с гипнотизером воспоминания могут вернуться через какой-либо временной промежуток по окончанию сеанса гипноза.

Инфантильная амнезия или детская амнезия – один из видов патологии, характеризующийся полным отсутствием воспоминаний о детстве у взрослого человека. На сегодняшний день патогенез развития инфантильной амнезии не изучен.

Возможные причины проявления детской амнезии обусловлены:

  • Ребенокутратой связи нейронов мозга;
  • активностью защитной функции психики.

Этиология детской амнезии имеет специфический характер, связанный с защитной функцией психики человека, не допускающий тотального осознания собственной уязвимости в период раннего возраста, так как это способствует значительному нарушению психики индивида в зрелом возрасте. Характеризуется как частичная амнезия и встречается довольно редко.

Репродукционная амнезия – это невозможность воспроизводить фиксированную информацию в необходимый момент времени. Регистрируется данный тип наиболее часто при астенических отклонениях, переутомлении, церебральном атеросклерозе.

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Классификация по динамике развития патологии

Классификация заболевания подразделяется на три вида амнезии:

  • Прогрессирующая амнезия. Это постепенное забывание различных фактов и событий из жизни человека. Индивид способен воспроизвести значительный объем необходимой информации из прошлого, однако, с течением времени события начинают забываться.

    ЗабывчивостьЭтот вид патологии также обусловлен невозможностью, со временем фиксировать новые факты. Информация, которая может длительное время фиксироваться в памяти это события из детства. Это характерная черта обусловлена тем, что старые сегменты мозга более устойчивы к стиранию данных и сохраняют раннюю информацию о прошедших событиях в жизни человека.

  • Ретардированная амнезия. Это запаздывающая потеря памяти. Определенный временной период стирается из памяти не сразу, а спустя некоторое время после патологического состояния организма. Патология возникает ввиду посттравматических состояний.
  • Регрессирующие отклонения памяти. Патологическое состояние, обусловленное постепенным восстановлением утерянных событий в памяти. Возникает в следующих ситуациях:

    • после выхода из наркоза;
    • травматизации черепных костей;
    • травматизации тканей, сосудов или оболочек головного мозга. Состояние также наблюдается при депрессивных расстройствах.
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Классификация по механизму развития заболевания

Психогенная амнезия – характеризуется внезапной утратой способности воспроизводить необходимую собирательную информацию, зафиксированную в памяти. Способность к фиксированию новой информации присутствует. А также психогенная амнезия характеризуется, отсутствуем поражений мозга. Наиболее распространенный вид неосознанных нарушений психических функций. Психогенная амнезия довольно часто регистрируется у детей в возрасте 12 – 17 лет и женщин.

Девушка задумаласьИстерическая амнезия – избирательное вытеснение из памяти фактов, возникающее в результате действия защитных механизмов.

Сенсорно-моторная амнезия характеризуется устоявшимся состоянием моторно-двигательного забывания. Привычное неконтролируемое состояние приведения мышц в напряжении, не контролируемое мозгом называется сенсорно-моторной амнезией. Сенсорно-моторная амнезия поддается коррекции при помощи индивидуально разработанного комплекса упражнений. Комплекс способен:

  • нейтрализовать последствия травматизации;
  • ускорить процесс согласования активности мышц тела;
  • помочь испытать прилив жизненных сил;
  • улучшить привычное вертикальное положение тела;
  • преобразить внешний вид в лучшую сторону.

Сенсорно-моторной амнезией страдают люди любой возрастной категории и пола.

Классическая терапия сенсорно-моторной амнезии не всегда способствует положительным результатам.

Сильная головная больТравматическая амнезия – патологическое изменение, вызванное травматизацией головы, например, удара или падение. Название данного типа болезни говорит само за себя. Травматическая амнезия наиболее часто имеет временный характер. Травматическая амнезия и ее степень эксплицированности зависит от состояния здоровья и индивидуальных особенностей человека.

Цифровая потеря памяти – это результат зависимости человека от интернет-ресурсов. Поисковые интернет-системы значительно упрощают жизнь человека и способствуют минимальной мозговой нагрузке. В связи с этим у людей ухудшилась функция памяти и способность к концентрации внимания.

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Синдром потери памяти и диагностика

Амнестический синдром характеризуется различными по эксплицированности отклонениями памяти. Сопровождается синдром яркими поведенческими изменениями индивида, а также ухудшается ориентирование на местности. Позже проявляется снижение интеллектуальных способностей. Индивиду не представляется возможность отличить главное от второстепенного.

Диагноз регистрируется на основании анамнеза пациента и характерной клинической картины. Диагностирование проводят с отклонениями памяти, характеризующимися поражением головного мозга.

Для установления диагноза проводят следующую диагностику:

  • Девушка у врачасобирают жизненный анамнез;
  • проводят внешний осмотр;
  • делают рентгенографию черепа;
  • делают электроэнцефалографию.

А также учитывают следующие факты:

  • имеющиеся отклонения на психологическом и эмоциональном уровне;
  • видение несуществующих объектов.

При тотальной амнезии воспоминания о событии, повлекшем отклонения памяти, специалист получает со слов свидетелей или близких больного.

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Лечение и прогноз

Целесообразно исключить посредством дифференциальной диагностики следующие факторы:

  • интоксикационные внешние воздействия;
  • обструктивные изменения и отклонения в работе головного мозга.

При диагностировании вышеперечисленных факторов терапия направлена на минимизацию патологических процессов. Современная фармакологическая индустрия позволяет применять медикаменты, запускающие холинергические процессы в мозге.

А также необходимо придерживаться особого личного общения с человеком, который потерял память:

  1. Парень с дедушкойКогда больной задает вопрос более одного раза, целесообразно предоставлять достоверные ответы каждый раз.
  2. Близких родственников и друзей называть по имени и обязательно озвучивать тип родственной связи.
  3. При поручении заданий, необходимо чтобы больной человек повторил их, так как произнесенная вслух информация фиксируется эффективнее.
  4. При некорректной поведенческой линии, следует помнить, что виной этому психическая патология.

При лечении амнезии применяются гипносуггестивная терапия и различные варианты психологическое воздействие на пациента. При соблюдении рекомендаций специалистов патология поддается успешной коррекции и возможен положительный прогноз.

Расстройства памяти различных видов оказывает влияние на социальную и трудовую адаптацию, способствует снижению уровня качества жизни, а также в крайне тяжелых случаях приводит к тотальной беспомощности человека. Существуют случаи, когда происходит полная потеря памяти без возможности восстановления.

Мероприятия по профилактике рассматриваемой патологии направлены на предотвращение возможной травматизации головного мозга, адекватную терапию, лечение вторичных осложнений, состояний, характеризующихся снижением перфузии мозговой ткани.

В случае следования всех рекомендаций патология имеет положительный прогноз.

Якутина Светлана
Якутина Светлана
Эксперт проекта OInsulte.ru
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