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Neuropsychology > Exam #3 > Flashcards

Exam #3 Flashcards

1
Q

MS: diagnosis requires “dissemination in time and space”

A
  • Space: evidence of scarring (plaques) in at least two separate areas of the CNS
  • Time: evidence that the plaques occurred at different points in time
  • Must be no other explanation
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2
Q

Fazekas scale

A

Measures white matter in brain for people with MS

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3
Q

Relapsing remitting

A

Most common, ups and downs

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4
Q

Secondary progressive

A

Develops over time, no remissions

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5
Q

Primary progressive

A

No eventual recovery, worsen

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6
Q

Progressive relapsing

A

No remission

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7
Q

Pathogenesis of MS (3)

A
  1. BBB: abnormally activated lymphocytes disrupt BBB
  2. Autoimmune: lymphocytes enter brain, activate local immune response
  3. Inflammation: t-cells attack on myelin and triggers inflammatory processes
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8
Q

Treatment of MS (5)

A
  1. Treatment of relapses
  2. Symptom management
  3. Disease modification
  4. Rehab
  5. Psychosocial support
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9
Q

What do disease-modifying drugs do for MS?

A

All reduce attack frequency and severity, reduce scarring on MRI, and probably slow disease progression

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10
Q

What does MS medications NOT do? (3)

A
  1. Cure the disease
  2. Make people feel better
  3. Alleviate symptoms
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11
Q

Where is seizure onset usually?

A

Left posterior medial temporal lobe

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12
Q

Ictal activity (during a seizure)

A

Stereotyped, driven behavior, not consciously controlled

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13
Q

Post-ictal activity (after a seizure)

A

Brain is “re-booting”, confusion, headache, fatigue

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14
Q

Inter-ictal (between seizures)

A

Ranges between normal and impaired, degree and type of dysfunction depends on location and severity of underlying abnormality

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15
Q

Treatment goal of epilepsy

A

Prevent start or spread of seizure activity

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16
Q

Treatment options for epilepsy (3)

A
  1. AED
  2. Neurostimulators
  3. Surgery
17
Q

Medial temporal lobe epilepsy (MTLE)

A
  • onset in 1st two decades
  • cryptogenic etiology
  • “stuttering” course
  • doesn’t respond well to medical treatment
  • significant psychosocial burden
  • 60-90% seizure free with surgery
  • memory worse in 25-40%
18
Q

Functional adequacy

A

Ability of MLT structures ipsilateral to seizure focus to support memory-how good the tissue is that you are removing, high functional adequacy associated with higher likelihood of post-op memory deficits, “the more you have, the more you have to lose”

19
Q

Functional reserve

A

Ability of MLT structure contralateral to seizure focus to support memory- making sure one side is good enough to function on its own, higher functional reserve associated with lower likelihood of post-op memory deficits, “the more you have left, the more you can make up for what is lost”

20
Q

Mechanism of TBI (3)

A
  1. Direct blow to head
  2. Indirect blow
  3. External force/blast wave
21
Q

4 mechanisms of blast injuries

A
  1. Primary blast mechanisms
  2. Secondary blast mechanisms
  3. Injury to the brain opposite side of impact (countrecoup)
  4. Site of impact (coup)
22
Q

Behaviors to classify TBI (3)

A
  1. Eye opening response
  2. Best verbal response
  3. Best motor response
23
Q

5 Parameters of TBI

A
  1. Loss of consciousness
  2. Altered consciousness
  3. Initial glasgow coma scale
  4. Neurological exam
  5. Imaging/EEG
24
Q

Shearing force

A

Unaligned forces pushing one part of the brain in one direction and another part of the brain in opposite direction

25
Q

Rotational force

A

The head and the brain are being rotated, which causes the axons to twist resulting in either temporary or permanent damage to the axon and neuron

26
Q

Where do contusions usually occur in the brain?

A

Prefrontal or anterior temporal region

27
Q

For moderate and severe TBIs, the primary pathophysiology includes (4)

A
  1. Diffuse axonal injury (DAI)
  2. Contusions
  3. Diffuse micro/small vessel injury
  4. Widespread cellular dysfunction, neurochemical disregulation, neurometabolic disruption, NT imbalances
28
Q

Secondary/delayed consequences of TBI (5)

A
  1. Hematoma
  2. Infection
  3. Anoxia/hypoxia
  4. Seizures
  5. Raised intracranial pressure
29
Q

Categories of cognitive rehab (2)

A
  1. Retraining (process): if circuits have been partially spared after injury, they can be retrained, takes time
  2. Develop compensatory skills (strategy): retained skills and functional reorganization used to learn new strategies, external tools (cognitive support tools)
30
Q

Compensatory approaches (4)

A
  1. Remediation (practice, memory tasks)
  2. Substitution (smart phone)
  3. Accommodation (adjust priorities, set new goals)
  4. Assimilation (adjust expectations of others)

Neuropsychology (3 decks)

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