Cognitive impairment after accidental high-dose corticosteroid therapy
- 1 October 2004
- journal article
- research article
- Published by Springer Science and Business Media LLC in Der Nervenarzt
- Vol. 75 (9), 904-907
- https://doi.org/10.1007/s00115-003-1638-7
Abstract
Synthetische Glukokortikosteroide können psychische Störungen verschiedenster Art verursachen. Eine seltene Komplikation der Therapie mit Kortikosteroiden hingegen stellen persistierende kognitive Defizite, insbesondere des Gedächtnisses, der Konzentration und der Aufmerksamkeit dar. Wir konnten Nebenwirkungen einer akzidentell selbstinduzierten, 20-tägigen Hochdosiskortisonbehandlung auf die kognitiven Funktionen bei einer 54-jährigen Patientin beobachten, nachdem differenzialdiagnostisch eine organisch bedingte Demenz ausgeschlossen worden war: Unmittelbar nach der Kortisoneinnahme fanden sich in den neuropsychologischen Untersuchungen schwere Beeinträchtigungen von Konzentration, Aufmerksamkeit, Lernen und Gedächtnis sowie allgemeiner Problemlösefähigkeit. Die nachfolgenden Verlaufskontrollen (1, 2, 4 und 6 Monate) verwiesen zwar auf eine Verbesserung der Konzentration und Aufmerksamkeitsleistungen, jedoch weiterhin vorliegende schwere Defizite des deklarativen Gedächtnisses mit hoher Konfabulationsneigung. Unsere Ergebnisse bestätigen vorliegende Literaturangaben zu humanexperimentellen Studien, dass exogene Steroide schwere, persistierende und spezifische, kognitive Defizite, besonders des deklarativen, hippocampusabhängigen Gedächtnisses verursachen können. Synthetic glucocorticosteroids can induce various severe mental disorders. Persisting cognitive disorder represents a rare complication of corticoid therapy involving memory, concentration, attention, or occupational performance. We observed the effects of a 20-day self-induced high-dose corticosteroid treatment on the cognitive functions in a 54-year-old patient. Having excluded dementia due to other organic causes, we examined the patient neuropsychologically immediately at the end of the steroid therapy and at follow-up (1, 2, 4, and 6 months). The initial tests showed seriously impaired functioning of concentration, attention, learning, and memory as well as of common ability to solve problems. The follow-up tests up to 6 months revealed an improvement of concentration and attention, but there were still serious deficits of the declarative memory with a high confabulating tendency. Our results confirm those of human experimental studies that exogenous steroids can cause serious persisting specific cognitive disorders especially of the declarative, hippocampus-dependent memory.Keywords
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