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Anatomic Syndromes Flashcards

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1
Q

Frontal Lobe Syndromes

A

Orbitofrontal Syndrome
Dorsolateral Frontal/Convexity Syndrome
Mesial Frontal Cortical Syndrome
Broca’s aphasia

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2
Q

Orbitofrontal Syndrome - anatomical function

A

the orbitofrontal area is involved with involuntary action, decision making, and socially appropriate behavior

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3
Q

Orbitofrontal Syndrome - Exam

A

socially inappropriate behavior including Witzelsucht (joking addiction), disinhibition, echopraxia, and utilization behavior (reaching out and using objects in the environment in an automatic behavior i.e. reflexively picking up a phone and bringing it to your ear)

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4
Q

Witzelsucht

A

joking addiction

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5
Q

utilization behavior

A

reaching out and using objects in the environment in an automatic manner i.e. reflexively picking up a phone and bringing it to your ear

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6
Q

Dorsolateral Frontal/Convexity Syndrome - anatomical function

A

involved with executive functions, working memory, and selective attention

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7
Q

Dorsolateral Frontal/Convexity Syndrome - Exam

A

poor attention, motor programming, and immediate recall

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8
Q

Good test to evaluate for dorsolateral abnormalities?

A

Wisconsin Card Sorting Test

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9
Q

Mesial Frontal Cortex Syndrome - AKA

A

medial frontal cortex or anterior cingulate circuit syndrome

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10
Q

Mesial Frontal Cortex Syndrome - anatomical function

A

the mesial frontal cortex mediates motivated behavior, such as initiation of movement or speech

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11
Q

Mesial Frontal Cortex Syndrome - exam

A

amotivation, apathy, and akinesis. Akinetic mutism can be seen in bilateral lesions. patients can be incontinent and may only eat or drink when fed.

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12
Q

Mesial Frontal Cortex Syndrome - treatment

A

methylphenidate

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13
Q

Mesial Frontal Cortex Syndrome - lesion

A

posterior inferior frontal gyrus

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14
Q

Broca’s aphasia - lesion

A

posterior inferior frontal gyrus

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15
Q

Temporal Lobe Syndromes

A

Kluver-Bucy Syndrome
Prosopagnosia/Visual agnosia
Capgras delusion
Apperceptive prosopagnosia
Associative prosopagnosia
Wernicke’s aphasia

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16
Q

Kluver-Bucy Syndrome - Lesion

A

bilateral temporal lesions involving the amygdala

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17
Q

Kluver-Bucy Syndrome - Exam

A

Hypermetamorphosis (urge to touch everything), compulsive eating, and hypersexuality

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18
Q

Prosopagnosia/Visual agnosia

A

failure to identify objects and faces by visual identification
note: may be able to do so by voice

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19
Q

Capgras delusion - Lesion

A

fusiform gyrus, occipito-temporal cortex
more often associated with right hemispheric lesions than left

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20
Q

Capgras delusion - exam

A

variant of prosopagnosia in which a patient believes that a friend, spouse, or a close family member has been replaced by an imposter

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21
Q

Apperceptive prosopagnosia - lesion

A

right occipital temporal area

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22
Q

apperceptive prosopagnosia - exam

A

impaired object recognition. They are unable to recognize faces. However, they may be able to recognize people based on non-face clues (i.e. clothing, skin color, or voice)

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23
Q

Associative prosopagnosia - lesion

A

right anterior temporal area, more often bilateral

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24
Q

associative prosopagnosia - exam

A

impaired object identification. can copy images but cannot identify an image

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25
Wernicke's aphasia - lesion
superior temporal gyrus
26
Parietal Lobe Syndromes
Dominant Parietal Lobe - Agraphesthesia - Astereogonsis - Ideomotorapraxia - Gerstmann's syndrome Non-dominant Parietal Lobe Balint's Syndrome
27
agraphesthesia
inability to recognize letters or numbers drawn by fingertip on the patient's skin
28
astereogonsis
inability to recognize object by touch
29
ideomotorapraxia
impaired understanding of tool functions i.e. can identify a key but can't explain what a key does
30
Gerstmann's syndrome - lesion
dominant inferior parietal lobe, AKA dominant angular and surpamarginal gyrus of the parietal lobe
31
Gerstmann's syndrome - exam
agraphia, acalculia, finger agnosia, and left/right confusion
32
Non-Dominant Parietal Lobe - Lesion
non-dominant angular and supramarginal gyrus
33
Non-Dominant Parietal Lobe - Exam
Anosognosia (unaware of deficit or illness) Sensory or receptive aprosodia (impaired ability to perceive emotions in others) Hemineglect Dressing apraxia
34
Balint's syndrome - lesion
bilateral parietal-occipital lobes
35
Balint's syndrome - exam
Triad Optic ataxia: the inability to move the hand properly to perform voluntary tasks Oculomotor apraxia: the inability to voluntarily fixate eyes to specific locations Simultagnosia: the inability to focus on multiple objects
36
Balint's syndrome - pathophysiology
watershed infarcts, multiple embolic strokes, or PRES
37
Occipital Lobe Syndromes
Anton Syndrome Achromatopsia
38
Anton Syndrome - Lesion
bilateral posterior cerebral artery territory infarction. Can also be seen in PRES
39
Anton Syndrome - Exam
Cortical blindness (the patient has true blindness, but they deny the presence of this blindness) - Patients will often confabulate in response. For example, if asked to identify the color of something, rather than saying "I can't see," they may say "it's blue."
40
Achromatopsia - lesion
inferior lip of the occipital lobe, often bilateral - could also present from a lesion to the thalamus
41
achromatopsia - exam
color blindness
42
Limbic Lobe Syndromes
Apathy
43
Apathy - lesion
anterior cingulate
44
Apathy - exam
bilateral lesions can cause akinesis and mutism
45
Subcortical Syndromes
Alexia without Agraphia Limb Kinetic Apraxia
46
Alexia without Agraphia - lesion
splenium of the corpus callosum and unilateral occipital lobe - can be seen after a unilateral posterior cerebral artery stroke
47
Alexia without Agraphia - exam
inability to read, but with retained ability to write
48
Limb Kinetic Apraxia - Lesion
anterior corpus callosum
49
Limb Kinetic Apraxia - exam
inability to perform tasks when aked (i.e. unable to brush hair when given a brush)
50
Brainstem Syndromes
Benedikt Claude Dejerine Locked in Marie-Foix Mollaret's Millard-Gubler Nothnagle Parinaud Wallenberg Weber
51
Benedikt syndrome - lesion
tegmentum of midbrain
52
Benedikt syndrome - symptoms
CN III palsy (ipsilesional), ataxia, tremor, and weakness (contralesional)
53
Claude syndrome - lesion
tegmentum of midbrain
54
Claude syndrome - symptoms
CN III palsy (ipsilesional), ataxia, tremor, and vertical gaze palsy (contralesional)
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Dejerine syndrome - lesion
medial medulla
56
Dejerine syndrome - symptoms
CN XII palsy (ipsilesional), hemiplegia and sometimes loss of position and vibration (contralesional)
57
Locked In Syndrome - lesion
central pons
58
Locked In Syndrome - symptoms
bilateral paralysis below neck
59
Marie-Foix - lesion
rostral pons. AICA and circumferential basilar perforators
60
Marie-Foix - symptoms
contralateral hypoesthesia to pain and temperature (spinothalamic tract). ipsilateral ataxia (MCP). Contralateral hemiparesis (corticospinal tract)
61
Mollaret's syndrome - lesion
Dentate nucleus, inferior olive, red nucleus
62
Mollaret's syndrome - symptoms
palatal myoclonus
63
Millard-Gubler syndrome - lesion
caudal medial pons
64
Millard-Gubler syndrome - symptoms
CN VI and VII palsy (ipsilesional), weakness (contralesional)
65
Nothnagle syndrome - lesion
tectum of midbrain
66
Nothnagle syndrome - symptoms
CN III palsy (ipsilesional), ataxia, and vertical gaze palsy (contralesional)
67
Parinaud syndrome - lesion
dorsal midbrain
68
Parinaud syndrome - symptoms
paralysis of upward gaze and accommodation
69
Wallenberg syndrome - lesion
lateral medulla
70
Wallenberg syndrome - symptoms
ataxia, loss of pain and temperature for face, weakness of soft palate, larynx and pharynx, Horner's (ipsilesional), loss of pain and temperature for body (contralesional)
71
Weber syndrome - lesion
medial midbrain
72
Weber syndrome - symtpoms
CN III palsy (ipsilesional), weakness, and vertical gaze palsy (contralesional)
73
Charles Bonnet Syndrome - lesion
seen in patients with severe vision loss secondary to a variety of pathologies (stroke, macular degeneration, etc)
74
Charles Bonnet syndrome - exam
complex visual hallucinations without other psychopathology, and with the self-awareness that the hallucinations are not real
75
Geschwind syndrome - lesion
controversial disorder thought to occur in some patients with temporal lobe epilepsy - some researchers question whether it actually exists
76
Geschwind syndrome - exam
presents as a personality syndrome with hypergraphia (compulsive writing), hyper-religiosity, and atypical sexuality (usually hyposexuality)
77
Alien hand syndrome - exam
presents with uncontrolled movements of an extremity, in the modern era most often seen in corticobasal degeneration, prion disease, and strokes
78
Alien hand syndrome - frontal variant
dominant hemisphere lesion of supplementary motor area or medial prefrontal cortex presents with right hand impulsively grabbing, groping, and manipulating objects. also can have utilization behavior usually follows an ACA stroke
79
alien hand syndrome - callosal variant
commonly due to callosal hemorrhage, demyelination, or surgery often has "intermanual conflict" (antagonizing movements of the two hands) often there are other disconnection symptoms present like apraxia, agraphia, or alexia
80
Alien Hand Syndrome - posterior variant
secondary to a non-dominant parietal lobe (posterior postcentral gyrus) lesion Associated with a strong feeling of estrangement from the affected limb, and abnormal posturing as well as "levetation" of the limb the variant is the one most commonly caused by corticobasal degeneration, Creutzfeld-Jakob disease, or stroke

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