Cholinergic Dysfunction: A Common Denominator in Metabolic Encephalopathies

  • J. P. Blass
  • G. E. Gibson
  • T. E. Duffy
  • F. Plum
Part of the Advances in Behavioral Biology book series (ABBI, volume 25)


The metabolic encephalopathies are a group of disorders of brain function secondary to systemic metabolic derangements. Both they and the disorders that cause them are common (Table 1). Clinically, the metabolic encephalopathies typically present as disorders of attention, cognition and arousal. The milder stages usually lead to a loss of interest and attentiveness, and the associated inability to carry out a complex task. More severe stages progress to obtundation, stupor and coma (25). Motor abnormalities such as asterixis, motor resistance to passive stretch, and ataxia also occur. Pupillary and oculomotor functions are commonly spared. The key to identifying the specific cause of metabolic encephopathy in an individual patient generally lies in the systemic manifestations or laboratory determinations since the neurological abnormalities tend to be stereotyped. This very stereotypy, in fact, suggests the hypothesis that the metabolic encephalopathies share at least some common neurochemical and neuropharmacological derangements.


Thiamine Deficiency Cholinergic Dysfunction Hypoxic Hypoxia Metabolic Encephalopathy Metabolic Insult 
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Copyright information

© Plenum Press, New York 1981

Authors and Affiliations

  • J. P. Blass
    • 1
    • 2
  • G. E. Gibson
    • 1
    • 2
  • T. E. Duffy
    • 1
    • 2
  • F. Plum
    • 1
    • 2
  1. 1.Department of NeurologyCornell University Medical CollegeNew YorkUSA
  2. 2.Dementia Research ServiceBurke Rehabilitation CenterWhite PlainsUSA

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