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Dr Basu
Dr Basu, Experienced Specialist
Category: Neurology
Satisfied Customers: 29273
Experience:  15 years' clinical experience
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Is there a way to differentiate between psychological &

Resolved Question:

Is there a way to differentiate between psychological & physical brain disorders with the following Symptoms;sudden onset anxiety,insomnia,unable to grasp time & place change in personality,feelings of psychosis & urinary retention
Submitted: 3 months ago.
Category: Neurology
Expert:  Dr Basu replied 3 months ago.

Hi there,
This is Dr Basu, experienced Internal Medicine Specialist.
I am here to address your concerns and provide great service.

Did all these symptoms start at same time?

Also are they worsening over time?

Do they appear together time and again and subside?

Customer: replied 3 months ago.
No it started with anxiety gradually getting worse,each symptom staying & not subsiding with last symptom being urinary retention
Customer: replied 3 months ago.
Is there a way to tell if the urinary retention is related to some brain disease or if its a bladder/prostate problem or just a psychological problem
Customer: replied 3 months ago.
Dr bass Having trouble seeing your answer
Expert:  Dr Basu replied 3 months ago.

Progressive worsening and not subsiding suggest less likelihood of psychological symptoms.

Expert:  Dr Basu replied 3 months ago.

When you say urinary retention, do you have urinary leakage and lack of ability to start urination?

Customer: replied 3 months ago.
Just unable to properly start urination
Expert:  Dr Basu replied 3 months ago.

Once you start urination, do you have good flow?
Also do you have any problem in holding urine for long time?

Customer: replied 3 months ago.
can hold for a long time he said just a trickle of urine & unable to start a normal flow
Expert:  Dr Basu replied 3 months ago.

Ok that suggests more likely prostate problem or overactive bladder problem.

Not likely neurological the bladder symptom at least.

Customer: replied 3 months ago.
If it was due to a brain disorder affecting the nerves would one have incontinence as well as retention?
Expert:  Dr Basu replied 3 months ago.

Yes that is correct incontinence is more consistent with brain or nerve problem.

Customer: replied 3 months ago.
He also complained of having "dim vision" like the lights were turned down his eyesight was checked & normal could certain brain diseases cause this or do you think it could be psychological{all in his mind?)
Expert:  Dr Basu replied 3 months ago.

With brain disease usually there will be loss of peripheral vision ( more like tunnel vision), or there will be double vision.

Any other type of vision abnormality is less likely.

Customer: replied 3 months ago.
What about dementia patients were the contrast is affected due to dying cells?
Expert:  Dr Basu replied 3 months ago.

In case of brain degeneration related dementia, memory loss is not noticed by the patient himself. The patient may find difficulty in remembering events, doing complex tasks like managing finances, finding right words during conversation.

Customer: replied 3 months ago.
OK one last question would an MRI scan show up degenerative brain disease or would this only show up in post mortem of the brain?
Expert:  Dr Basu replied 3 months ago.

MRI scan with contrast should show degenerative brain disease as form of brain volume loss, or hippocampal atrophy or dilated ventricles for example.

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