Дегенерация мозга. Болезнь Альцгеймера © Dementia. Brain degeneration. Alzheimer's disease. МЕДФИЛЬМ — Transcript

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1. 0:00A 66-year-old patient with no family history.
2. 0:08Born in a rural area, she worked in the city in a low-skilled job. After
3. 0:14receiving her pension, she continued working at the factory as a storekeeper. However, about a year ago, she could no longer
4. 0:21cope with the work and was forced to quit. She was examined by a psychiatrist at the initiative of her relatives.
5. 0:28Maria Frolovna, is something bothering you? Well, it is, of course. Complain. And about your heart,
6. 0:37is your heart bothering you, yes? Mm-hmm. Well, what about your heart? My heart is a source of victory here.
7. 0:48Maria Frolovna, how about your memory? My memory is bad. Bad, yes. Is it really bad,
8. 0:58or do you still remember more or less where we are now? What is this?
9. 1:07An institute, probably some kind of institute, yes. Well, I am now. And what does this institute do? It deals
10. 1:14with our affairs. What affairs? You You us this And you you us you now this Aha. Well, you work
11. 1:26with us, we thank you, of course. And what is my profession? Maria Frolovna.
12. 1:33I had a profession, a profession. What profession do you think I have? Profession has said it all.
13. 1:42Well, that's it, profession. Profession, what is my profession? How can I tell you? Profession. Well, who am I?
14. 1:56Mathematician, chemist, physicist, salesman, hairdresser. Who am I? Who am I? No. Well, you are not a salesman. Nobody.
15. 2:04No. And who am I? Well, who are you? Well, you are not a salesman. I can't say that.
16. 2:10Well, I understand. And what is my profession? You will tell me later. You will say this. And what is my profession then?
17. 2:18Profession. Well, we will have to look at you. Uh-huh. You don't know why you are here? Have you been here for a long time,
18. 2:27in this building? Not in this building. Well, how long, approximately? A month, a year, a week?
19. 2:40No, this is a year. No, a year, a whole year. Wait, wait, I'm right now, right now, right now. I've got you all
20. 2:47confused, confused, confused. Oh well. You've been here for a few weeks.
21. 2:53Do you know what year it is now? Yes. At the clinic. Clinic. This is a clinic. What's the name of the clinic, do you know? No. Yeah.
22. 3:01I don't know. I'm just like that. So, you can't tell me my profession, if what is my profession then,
23. 3:07if we're all in the clinic? In the clinic? Right. And who am I here? In the clinic? You're a doctor. I'm a doctor. That's it.
24. 3:15Absolutely right. Okay. Maria Frouna. Don't know what year it is now? Year? Yes. I could be
25. 3:25wrong, you could kill yourself. Well, I'll say it's 1995. Don't you know the month? Month.
26. 3:38I know the month. Oh, no way. What time of year is it now? Time, time, years.
27. 3:48Mm, what time of year?
28. 3:57Well, just a little bit. Well, what is it now? Winter, spring, summer, fall. What is it now? Fall.
29. 4:04It's autumn now, right. And you don't know the month? Month. I know the month. Which one? Which month? What month is it now?
30. 4:15Can you list the months of the year for me. What months of the year do you know? Month. Month year.
31. 4:26Well, the year starts in January. Next month. January, February, March, April, May, June, July,
32. 4:32August, October, November, December. Aha. You missed it. We only missed September.
33. 4:40So. I see. Also, Maria Frolna, what are the names of the fingers? Can you name them for me?
34. 4:48Come on, name them, what are the names of the fingers. Which finger is this? No. And this? This.
35. 4:59Well, what other fingers do you know? No, not now.
36. 5:04This is which January. Now I am January, February, March. Ma is going again. You started telling me
37. 5:12the months of the year, and I need the name of a finger. So, this is the little finger. And what finger is this?
38. 5:24Like one? Yes. And what finger is this?
39. 5:28Call it the thumb. What's your finger like? Your thumb, right. And that thumb is your thumb. And what about this,
40. 5:42you
41. 5:43don't remember? It's okay, it's your middle finger. I'm just hanging out. Are you embarrassed? Yes. Be embarrassed. So,
42. 5:52in her senile years, a patient developed severe memory and intellectual impairment. A decrease in critical thinking and
43. 6:00a serious error in comprehending situations suggest that her condition is total dementia.
44. 6:07The richness of her symptoms suggests diffuse brain damage.
45. 6:14Vascular disease can be safely ruled out, as lacunar dementia would be observed in that case.
46. 6:19Note the dertria and approxia in this patient.
47. 6:25But you speak so unclearly. Maria Frouvna, are you speechless?
48. 6:32No, your tongue is fine. You've always spoken clearly. What's
49. 6:42stopping you from speaking? No, nothing's stopping you. Nothing's stopping you.
50. 6:46Well, then tell me clearly. Yogurt whey. Loud and clear. Serum
51. 6:54from under the krashinjach. Repeat again, but more clearly and loudly. Serum from under the krashinjach, I just can't do it.
52. 7:06You can't. This is a difficult task for you. It's not difficult. But it's weighty. Aha. Here's Maria Provna. Then
53. 7:14here's the task. I have some matches, and I'll make a simple figure out of these matches.
54. 7:31Do you see how simple the figure is? What does it look like?
55. 7:36Well, if that's the case, then, as the childish saying goes, yes. Like a house on a house, yes. Can you
56. 7:46build me such a figure? A figure? Uh-huh. The one that was. Build it for me. Can't you see how now
57. 8:03I can't make a house, you see? Aha.
58. 8:06Come on, try. It always worked before, but not now. Aha. It turns out
59. 8:18like this, my hands.
60. 8:30Vorobyov just has to catch me. So, the same way I'll build it, did it work or not? You're
61. 8:39better than me. Can you fix anything else to make it better?
62. 8:52You do everything with all this shaking. Your hands are clumsy, aren't they? Aha. Well, what did you get?
63. 9:02What did you get? What were we building?
64. 9:08I was building
65. 9:12a little house, we were supposed to have one. Yes, a little house. Then another.
66. 9:20Uh-huh. It’s not working. Well, that’s okay. Maria Frolovna, can you describe it? Now write down
67. 9:30your last name, first name, and patronymic.
68. 9:57Okay. Ah, and now draw me a triangle below.
69. 10:07What am I? Well, it didn’t work. Here, here, in the middle, draw a triangle.
70. 10:26Well, Rifrovna, you wrote, yes, and then look,
71. 10:30something happened with the letters here. My hands are shaking, that’s why I can’t somehow. Okay,
72. 10:36here is the letter T, R, I, and look here, there are some extra ones. What letter is this?
73. 10:48What did you write here? Can you read it? No, I don’t have my glasses. Aha.
74. 10:59What did you write?
75. 11:04Can’t read it? No, I can read it. But this, I can’t. Well, read it. Okay,
76. 11:13it’s not working. Okay, Mari Krovna, I'll take a pen and put the cap on it. Can you
77. 11:22write something for me with this pen now? Can't you write with this pen? Yes. Yes. You have a different pen there,
78. 11:32a different card, of course. Well, and to write with it, you need to take off the cap. You can do that. A bud, right?
79. 11:47Isn't that how it works? No, well, you see, there's no line at all.
80. 11:50To write with this pen, you need to take off the cap. Here, take the cap off this. Uh-huh.
81. 12:02No, the pen doesn't leave any traces like that.
82. 12:06And those who wrote, you need to take off the cap. You can take the cap off.
83. 12:15No, I can't. Uh-huh. On the other side. Here's the cap. Come on.
84. 12:25First on the other side, then on the other side. Uh-huh. I can't. Well, that's how it comes off.
85. 12:31And then you get a pen. Can you draw me a triangle? Draw a triangle.
86. 12:42Incorrect.
87. 12:47Write again. No, just don't draw or write. Just draw, right? Yeah.
88. 12:55That's what
89. 12:56I'm saying too.
90. 13:01So, what are you doing?
91. 13:04There should be a triangle here. Yeah. Okay, like this. Let's make it whatever you want.
92. 13:21Yeah. Well, we're really tired. Look, we finally wrote Tr. The E is completely gone, the G has two O's.
93. 13:33Extra letters have appeared. I see. The patient is completely helpless, can't perform the simplest practical
94. 13:41actions, skips letters, and repeats herself when writing. There is disorthria
95. 13:48and elements of formal criticism of the disease. All this is characteristic of Alzheimer's disease, which
96. 13:54manifests itself as diffuse multifocal degeneration of the brain, prone to steady progression.
97. 14:04Ra