2 research outputs found
Study on Neurological Soft Signs in patients with Obsessive Compulsive Disorder.
INTRODUCTION:
In the era of expanding recent advancements and progress made in
The field of neuro psychiatry , a relatively neglected aspect is complete
Neurological examination which is non invasive, easy to administer and
Provides wealth of information regarding the various aspects of the
Disease. Impaired neurological performance has been documented in
Various psychiatric conditions and the concept of neurological
Examination in psychiatry ,a time old concept whose significance has
Gained importance with blurring of the thin line between neurology and
Psychiatry leading to the concept of neuropsychiatry. Neuro biological
Underpinnings of psychiatric conditions further propelled the significance
Of neurological examination in psychiatry.
Neurological examination in psychiatry, particularly has two
General aspects
1] Examination for âhard signsâ or âmajor signsâ or âlocalizable
Signsâ such as cranial nerve lesion, motor deficit, sensory impairment,
Reflex asymmetry which reflects presence or absence of neuropathology
And a localizing lesion.
2] Evaluation of performance decrements in neurological domains
Without any identifiable neurological lesion or disorder (Sanders &
Keshavan, 1998).
As mentioned above these decrements in neurological domains
Mainly includes the concept of our focus âNEUROLOGICAL SOFT
SIGNSâ or âSOFT NEUROLOGICAL SIGNSâ.(Sanders & Keshavan,
1998)
NEUROLOGICAL SOFT SIGNS
Dr. Loretta Bender ,a pioneer in neuro psychiatric aspects of
Childhood disorders introduced the concept of neurological soft signs in
1947 in reference to non diagnostic neurological abnormalities seen in
Children with schizophrenia .(Sadock, Benjamin James., Sadock, 2007)
DEFINITION
NSS are defined by Shaffer and oâconnor as
â Non normative performance (s) on a motor or sensory test(s)
Which would be identical or akin to test(s) of traditional neurological
Examination, but elicited from an individual who shows none of the
Features of fixed or transient neurological disorder â
Shaffer et al also proposed that to consider a sign as an NSS it should
Have following features
1] No association should exist between an observed behaviour and
A positive history of neurological disease or trauma
2] It should not be a pathognomonic sign of any neurologic disease
Or encephalopathy
3] It should not be indicate any specific CNS pathology
Thus the NSS are minor neurological deviation in motor and sensory
Function that are not localized to any specific area of the brain and not
Characteristic of any specific neurological condition ,mostly indicating
Diffuse cerebral dysfunction.
Ever since they have been introduced they were termed as âsoft
Signsâ, ânon focal signsâ, âdiffuse signsâ, âminimal brain damage
Syndromeâ due to their lack of specificity ,validity or localization at that
Time. The term âsoftâ also signifies the nature of wide but blurred
Boundaries of varying domains like EEG findings ,behaviour disturbance,
Learning disorders, neurological functions that were considered under the
Umbrella of soft signs.(Sanders & Keshavan, 1998)
The initial focus of these NSS remained mainly in the field of child
Psychiatry with description of concepts of âMinimal Brain Damageâ in
Children with hyperactivity, impulsivity and with no demonstrable
Neurological lesion. Later from 1990 with quantification of validated and
Standardised instruments for assessment of these signs, the focus shifted
To major psychiatric conditions leading to exhaustive research in the
Subject which provided significant understanding of the neurobiology,
Neuro anatomical correlates, genetic underpinnings , neuro developmental
Basis, endophenotypic markers and predictors of neuropsychological
Dysfunction in certain psychiatric conditions.
With this brief introduction about the neurological soft signs ,we
Now focus on existing documented literature that has changed the concept
Of these NSS, their significance in psychiatric conditions and the various
Aspects of their relation to Obsessive compulsive disorder which is the
Main focus of our study
Intellectual disability in international classification of Diseases-11: A developmental perspective
Historically Intellectual Disability (ID) has been included in the International Classification of Disease and related Health Problems [ICD] and Diagnostic and Statistical manual Of Mental Disorders [DSM] from the beginning. There has been a significant change in the terminology, placement of the condition, classification, and defining features as a result of advances in unraveling the development and functionality of the brain and identifying the etiologic basis of intellectual disability. Current approaches view ID from a developmental perspective and rely on both intellectual abilities and adaptive functioning. This article looks into the salient features of âDisorders of Intellectual Developmentâ as it is termed in ICD-11 in comparison with âMental Retardationâ as it was termed in previous ICD-10 and âIntellectual Developmental Disorderâ in latest DSM-5 version, and examines the commonalities and differences