Clinical manifestations of disease are in the final analysis the result of altered physiologic or biochemical relations. This is true whether one observes the direct evidence of abnormal function or the compensatory reactions invoked to counteract abnormal forces. The central nervous system is no exception to this principle. And this is no less true whether one deals with disease directly involving the central nervous system or with the effects on it of disease having its origin elsewhere. This report is concerned with secondary effects. Neuropsychiatric complications of underlying disease may vary widely from mild aberrations of normal mood and behavior to sweeping disturbances that dominate the entire clinical picture and may obscure the disease itself.
The basis for these reactions depends primarily on the fundamental nature of brain metabolism. The central nervous system has the most exacting metabolic requirements in the body. Unlike other tissues, it is primarily aerobic in
ENGEL GL, MARGOLIN SG. NEUROPSYCHIATRIC DISTURBANCES IN INTERNAL DISEASE: METABOLIC FACTORS AND ELECTROENCEPHALOGRAPHIC CORRELATIONS. Arch Intern Med (Chic). 1942;70(2):236–259. doi:10.1001/archinte.1942.00200200056004
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